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Insulin resistance and impaired glucose tolerance in overweight and obese Costa Rican schoolchildren.
Food Nutr Bull 2008; 29(2):123-31FN

Abstract

BACKGROUND

Worldwide obesity has become an unprecedented public health challenge. In addition, a notable increase in the risk of insulin resistance and type 2 diabetes mellitus has emerged. In Costa Rica, there are no epidemiological data to establish the prevalence of type 2 diabetes in the pediatric population. However, information from the Endocrinology Department of the Children's National Hospital indicates an increased number of cases in the last 2 to 3 years.

OBJECTIVE

To determine the prevalence of insulin resistance and impaired glucose tolerance in overweight and obese schoolchildren.

METHODS

This cross-sectional study was conducted among 214 healthy 8- to 10-year-old children from urban schools of San José, Costa Rica. Anthropometric measurements and blood determinations of glucose, insulin, proinsulin, glycosylated hemoglobin, C-peptide, and leptin were performed. Indexes were calculated to assess insulin resistance. Information on social and lifestyle variables was obtained from questionnaires, and acanthosis nigricans was certified by a physician. Statistical analysis was performed with SPSS software for Windows, version 10.0.

RESULTS

The prevalence of type 2 diabetes mellitus was very low (0.5%) in the studied population. However, hyperinsulinemia and impaired glucose tolerance were present in 20.6% and 6.5% of the subjects, respectively. On the basis of the Fasting Glucose-to-Insulin Resistance Ratio (FGIR), 46.7% of the children showed insulin resistance. Girls and obese children (body mass index > or = 95th percentile) were more likely to have higher serum insulin levels and insulin resistance than boys and overweight children (BMI > or = 85th percentile). Compared with the lowest quintile, children in the highest quintile of body-fat tissue had higher insulin resistance but had similar serum concentrations of glucose, C-peptide, and proinsulin. Positive family histories of type 2 diabetes mellitus and sedentarism (73.7% and 40.7%, respectively) were highly prevalent among overweight and obese children.

CONCLUSIONS

The prevalence of impaired glucose tolerance and insulin resistance in obese children indicates a worrisome trend in the incidence of type 2 diabetes in Costa Rica. Strategies for weight reduction, obesity prevention, and promotion of healthy lifestyles are necessary to prevent the onset of type 2 diabetes during childhood and adolescence.

Authors+Show Affiliations

Faculty of Microbiology and Hematological Investigation Center and Related Sicknesses (CIHATA), University of Costa Rica, San José, Costa Rica. iholst@cariari.ucr.ac.crNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18693476

Citation

Holst-Schumacher, Ileana, et al. "Insulin Resistance and Impaired Glucose Tolerance in Overweight and Obese Costa Rican Schoolchildren." Food and Nutrition Bulletin, vol. 29, no. 2, 2008, pp. 123-31.
Holst-Schumacher I, Nuñez-Rivas H, Monge-Rojas R, et al. Insulin resistance and impaired glucose tolerance in overweight and obese Costa Rican schoolchildren. Food Nutr Bull. 2008;29(2):123-31.
Holst-Schumacher, I., Nuñez-Rivas, H., Monge-Rojas, R., & Barrantes-Santamaría, M. (2008). Insulin resistance and impaired glucose tolerance in overweight and obese Costa Rican schoolchildren. Food and Nutrition Bulletin, 29(2), pp. 123-31.
Holst-Schumacher I, et al. Insulin Resistance and Impaired Glucose Tolerance in Overweight and Obese Costa Rican Schoolchildren. Food Nutr Bull. 2008;29(2):123-31. PubMed PMID: 18693476.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Insulin resistance and impaired glucose tolerance in overweight and obese Costa Rican schoolchildren. AU - Holst-Schumacher,Ileana, AU - Nuñez-Rivas,Hilda, AU - Monge-Rojas,Rafael, AU - Barrantes-Santamaría,Mauro, PY - 2008/8/13/pubmed PY - 2008/10/10/medline PY - 2008/8/13/entrez SP - 123 EP - 31 JF - Food and nutrition bulletin JO - Food Nutr Bull VL - 29 IS - 2 N2 - BACKGROUND: Worldwide obesity has become an unprecedented public health challenge. In addition, a notable increase in the risk of insulin resistance and type 2 diabetes mellitus has emerged. In Costa Rica, there are no epidemiological data to establish the prevalence of type 2 diabetes in the pediatric population. However, information from the Endocrinology Department of the Children's National Hospital indicates an increased number of cases in the last 2 to 3 years. OBJECTIVE: To determine the prevalence of insulin resistance and impaired glucose tolerance in overweight and obese schoolchildren. METHODS: This cross-sectional study was conducted among 214 healthy 8- to 10-year-old children from urban schools of San José, Costa Rica. Anthropometric measurements and blood determinations of glucose, insulin, proinsulin, glycosylated hemoglobin, C-peptide, and leptin were performed. Indexes were calculated to assess insulin resistance. Information on social and lifestyle variables was obtained from questionnaires, and acanthosis nigricans was certified by a physician. Statistical analysis was performed with SPSS software for Windows, version 10.0. RESULTS: The prevalence of type 2 diabetes mellitus was very low (0.5%) in the studied population. However, hyperinsulinemia and impaired glucose tolerance were present in 20.6% and 6.5% of the subjects, respectively. On the basis of the Fasting Glucose-to-Insulin Resistance Ratio (FGIR), 46.7% of the children showed insulin resistance. Girls and obese children (body mass index > or = 95th percentile) were more likely to have higher serum insulin levels and insulin resistance than boys and overweight children (BMI > or = 85th percentile). Compared with the lowest quintile, children in the highest quintile of body-fat tissue had higher insulin resistance but had similar serum concentrations of glucose, C-peptide, and proinsulin. Positive family histories of type 2 diabetes mellitus and sedentarism (73.7% and 40.7%, respectively) were highly prevalent among overweight and obese children. CONCLUSIONS: The prevalence of impaired glucose tolerance and insulin resistance in obese children indicates a worrisome trend in the incidence of type 2 diabetes in Costa Rica. Strategies for weight reduction, obesity prevention, and promotion of healthy lifestyles are necessary to prevent the onset of type 2 diabetes during childhood and adolescence. SN - 0379-5721 UR - https://www.unboundmedicine.com/medline/citation/18693476/Insulin_resistance_and_impaired_glucose_tolerance_in_overweight_and_obese_Costa_Rican_schoolchildren_ L2 - http://journals.sagepub.com/doi/full/10.1177/156482650802900206?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -