Underdiagnosis of Metabolic Syndrome in Non-Hispanic Black Adolescents: A Call for Ethnic-Specific Criteria

Current Cardiovascular Risk Reports

Volumn 4, Issue 4, 2010, Pages 302-310

  DeBoer, Mark D ^a  

^a UNIVERSITY OF VIRGINIA   (United States)

Author keywords

Cardiovascular disease; Diabetes; Ethnic differences; Inflammation; Insulin resistance; Metabolic syndrome

Indexed keywords

EID: 85027934087     PISSN: 19329520     EISSN: 19329563     Source Type: Journal    
DOI: 10.1007/s12170-010-0104-x     Document Type: Review

References (85)

1. Narayan KM, Boyle JP, Thompson TJ, et al.: Lifetime risk for diabetes mellitus in the United States. JAMA 2003, 290: 1884-1890.
2. Savoye M, Shaw M, Dziura J, et al.: Effects of a weight management program on body composition and metabolic parameters in overweight children: a randomized controlled trial. JAMA 2007, 297: 2697-2704.
3. • Wilfley DE, Stein RI, Saelens BE, et al.: Efficacy of maintenance treatment approaches for childhood overweight: a randomized controlled trial. JAMA 2007, 298: 1661-1673 This randomized trial demonstrated that by using time-intensive efforts, children and their families were able to lose weight and maintain weight loss (change in body mass index z-score of 0. 24) over a 30-month period. Such programs are likely to be more expensive that clinical programs that are currently available.
4. Reaven GM: Banting lecture 1988. Role of insulin resistance in human disease. Diabetes 1988, 37: 1595-1607.
5. DeBoer MD, Gurka MJ: Ability among adolescents for the metabolic syndrome to predict elevations in factors associated with type 2 diabetes and cardiovascular disease: Data from the National Health and Nutrition Examination Survey (NHANES) 1999-2006. Metab Syndrome Related Disord 2010 (in press).
6. •• Morrison JA, Friedman LA, Wang P, Glueck CJ: Metabolic syndrome in childhood predicts adult metabolic syndrome and type 2 diabetes mellitus 25-30 years later. J Pediatr 2008, 152: 201-206 This is a prospective study that demonstrated that MetS in childhood predicts future T2DM. Children had metabolic measurements at 6-18 years of age and were evaluated 25-30 years later for the development of diabetes. Children with MetS were 12 times as likely to develop T2DM.
7. Coppen AM, Risser JA, Vash PD: Metabolic syndrome resolution in children and adolescents after 10 weeks of weight loss. J Cardiometab Syndr 2008, 3: 205-210.
8. Park YW, Zhu S, Palaniappan L, et al.: The metabolic syndrome: prevalence and associated risk factor findings in the US population from the Third National Health and Nutrition Examination Survey, 1988-1994. Arch Intern Med 2003, 163: 427-436.
9. •• Sumner AE: Ethnic differences in triglyceride levels and high-density lipoprotein lead to underdiagnosis of the metabolic syndrome in black children and adults. J Pediatr 2009, 155: S7. e7-S7. e11 This review details ethnic differences in individual components of MetS.
10. •• de Ferranti S, Mozaffarian D: The perfect storm: obesity, adipocyte dysfunction, and metabolic consequences. Clin Chem 2008, 54: 945-955 This review describes molecular features of processes underlying insulin resistance in MetS.
11. Yamauchi T, Kamon J, Waki H, et al.: The fat-derived hormone adiponectin reverses insulin resistance associated with both lipoatrophy and obesity. Nat Med 2001, 7: 941-946.
12. Berg AH, Combs TP, Scherer PE: ACRP30/adiponectin: an adipokine regulating glucose and lipid metabolism. Trends Endocrinol Metab 2002, 13: 84-89.
13. Maeda N, Shimomura I, Kishida K, et al.: Diet-induced insulin resistance in mice lacking adiponectin/ACRP30. Nat Med 2002, 8: 731-737.
14. Ouchi N, Kihara S, Arita Y, et al.: Adiponectin, an adipocyte-derived plasma protein, inhibits endothelial NF-kappaB signaling through a cAMP-dependent pathway. Circulation 2000, 102: 1296-1301.
15. Weyer C, Funahashi T, Tanaka S, et al.: Hypoadiponectinemia in obesity and type 2 diabetes: close association with insulin resistance and hyperinsulinemia. J Clin Endocrinol Metab 2001, 86: 1930-1935.
16. Stefan N, Bunt JC, Salbe AD, et al.: Plasma adiponectin concentrations in children: relationships with obesity and insulinemia. J Clin Endocrinol Metab 2002, 87: 4652-4656.
17. Huang KC, Lue BH, Yen RF, et al.: Plasma adiponectin levels and metabolic factors in nondiabetic adolescents. Obes Res 2004, 12: 119-124.
18. Martin LJ, Woo JG, Daniels SR, et al.: The relationships of adiponectin with insulin and lipids are strengthened with increasing adiposity. J Clin Endocrinol Metab 2005, 90: 4255-4259.
19. Aguirre V, Uchida T, Yenush L, et al.: The c-Jun NH(2)-terminal kinase promotes insulin resistance during association with insulin receptor substrate-1 and phosphorylation of Ser(307). J Biol Chem 2000, 275: 9047-9054.
20. Harman-Boehm I, Blüher M, et al.: Macrophage infiltration into omental versus subcutaneous fat across different populations: effect of regional adiposity and the comorbidities of obesity. J Clin Endocrinol Metab 2007, 92: 2240-2247.
21. • Tilg H, Moschen AR: Inflammatory mechanisms in the regulation of insulin resistance. Mol Med 2008, 14: 222-231 This review highlights molecular processes linking inflammation, adipokines, and reduced insulin signaling.
22. Dandona P, Aljada A, Bandyopadhyay A: Inflammation: the link between insulin resistance, obesity and diabetes. Trends Immunol 2004, 25: 4-7.
23. Danesh J, Wheeler JG, Hirschfield GM, et al.: C-reactive protein and other circulating markers of inflammation in the prediction of coronary heart disease. N Engl J Med 2004, 350: 1387-1397.
24. Pradhan AD, Manson JE, Rifai N, et al.: C-reactive protein, interleukin 6, and risk of developing type 2 diabetes mellitus. JAMA 2001, 286: 327-334.
25. Petersen KF, Befroy D, Dufour S, et al.: Mitochondrial dysfunction in the elderly: possible role in insulin resistance. Science 2003, 300: 1140-1142.
26. Gregor MF, Hotamisligil GS: Thematic review series: Adipocyte Biology. Adipocyte stress: the endoplasmic reticulum and metabolic disease. J Lipid Res 2007, 48: 1905-1914.
27. Hosogai N, Fukuhara A, Oshima K, et al.: Adipose tissue hypoxia in obesity and its impact on adipocytokine dysregulation. Diabetes 2007, 56: 901-911.
28. Furukawa S, Fujita T, Shimabukuro M, et al.: Increased oxidative stress in obesity and its impact on metabolic syndrome. J Clin Invest 2004, 114: 1752-1761.
29. Qatanani M, Lazar MA: Mechanisms of obesity-associated insulin resistance: many choices on the menu. Genes Dev 2007, 21: 1443-1455.
30. Carvalho-Filho MA, Ueno M, Hirabara SM, et al.: S-nitrosation of the insulin receptor, insulin receptor substrate 1, and protein kinase B/Akt: a novel mechanism of insulin resistance. Diabetes 2005, 54: 959-967.
31. Kaneki M, Shimizu N, Yamada D, Chang K: Nitrosative stress and pathogenesis of insulin resistance. Antioxid Redox Signal 2007, 9: 319-329.
32. Pauli JR, Ropelle ER, Cintra DE, et al.: Acute physical exercise reverses S-nitrosation of the insulin receptor, insulin receptor substrate 1 and protein kinase B/Akt in diet-induced obese Wistar rats. J Physiol 2008, 586: 659-671.
33. •• Defronzo RA: Banting Lecture. From the triumvirate to the ominous octet: a new paradigm for the treatment of type 2 diabetes mellitus. Diabetes 2009, 58: 773-795 This fantastic treatise extensively details processes related to insulin resistance and β-cell failure leading to T2DM.
34. Després JP, Lemieux I: Abdominal obesity and metabolic syndrome. Nature 2006, 444: 881-887.
35. Mittelman SD, van Citters GW, Kirkman EL, Bergman RN: Extreme insulin resistance of the central adipose depot in vivo. Diabetes 2002, 51: 755-761.
36. Maheux P, Azhar S, Kern PA, et al.: Relationship between insulin-mediated glucose disposal and regulation of plasma and adipose tissue lipoprotein lipase. Diabetologia 1997, 40: 850-858.
37. Schneider JG, von Eynatten M, Schiekofer S, et al.: Low plasma adiponectin levels are associated with increased hepatic lipase activity in vivo. Diabetes Care 2005, 28: 2181-2186.
38. Li C, Ford ES: Is there a single underlying factor for the metabolic syndrome in adolescents? A confirmatory factor analysis. Diabetes Care 2007, 30: 1556-1561.
39. Pausova Z: From big fat cells to high blood pressure: a pathway to obesity-associated hypertension. Curr Opin Nephrol Hypertens 2006, 15: 173-178.
40. Paulmyer-Lacroix O, Boullu S, Oliver C, et al.: Expression of the mRNA coding for 11beta-hydroxysteroid dehydrogenase type 1 in adipose tissue from obese patients: an in situ hybridization study. J Clin Endocrinol Metab 2002, 87: 2701-2705.
41. • Mathieu P, Poirier P, Pibarot P, et al.: Visceral obesity: the link among inflammation, hypertension, and cardiovascular disease. Hypertension 2009; 53: 577-584 This review demonstrates many adverse roles that visceral adipocytes play in worsening MetS.
42. Paolisso G, Tagliamonte MR, Rizzo MR, et al.: Lowering fatty acids potentiates acute insulin response in first degree relatives of people with type II diabetes. Diabetologia 1998, 41: 1127-1132.
43. Clore JN, Stillman J, Sugerman H: Glucose-6-phosphatase flux in vitro is increased in type 2 diabetes. Diabetes 2000, 49: 969-974.
44. Gastaldelli A, Baldi S, Pettiti M, et al.: Influence of obesity and type 2 diabetes on gluconeogenesis and glucose output in humans: a quantitative study. Diabetes 2000, 49: 1367-1373.
45. Ford ES, Li C, Cook S, Choi HK: Serum concentrations of uric acid and the metabolic syndrome among US children and adolescents. Circulation 2007, 115: 2526-2532.
46. Hanley AJ, Williams K, Gonzalez C, et al.; San Antonio Heart Study; Mexico City Diabetes Study; Insulin Resistance Atherosclerosis Study: Prediction of type 2 diabetes using simple measures of insulin resistance: combined results from the San Antonio Heart Study, the Mexico City Diabetes Study, and the Insulin Resistance Atherosclerosis Study. Diabetes 2003, 52: 463-469. (Published erratum appears in Diabetes 2003, 52: 1306.).
47. Wannamethee SG, Shaper AG, Lennon L, Morris RW: Metabolic syndrome vs Framingham Risk Score for prediction of coronary heart disease, stroke, and type 2 diabetes mellitus. Arch Intern Med 2005, 165: 2644-2650.
48. Cook S, Weitzman M, Auinger P, et al.: Prevalence of a metabolic syndrome phenotype in adolescents: findings from the third National Health and Nutrition Examination Survey, 1988-1994. Arch Pediatr Adolesc Med 2003, 157: 821-827.
49. Ford ES, Li C, Zhao G, et al.: Prevalence of the metabolic syndrome among U. S. adolescents using the definition from the International Diabetes Federation. Diabetes Care 2008, 31: 587-589.
50. • Johnson WD, Kroon JJ, Greenway FL, et al.: Prevalence of risk factors for metabolic syndrome in adolescents: National Health and Nutrition Examination Survey (NHANES), 2001-2006. Arch Pediatr Adolesc Med 2009, 163: 371-377 This report from NHANES provides the most current evaluation of individual components of MetS among adolescents.
51. Arslanian S, Suprasongsin C, Janosky JE: Insulin secretion and sensitivity in black versus white prepubertal healthy children. J Clin Endocrinol Metab 1997, 82: 1923-1927.
52. Gower BA, Granger WM, Franklin F, et al.: Contribution of insulin secretion and clearance to glucose-induced insulin concentration in African-American and Caucasian children. J Clin Endocrinol Metab 2002, 87: 2218-2224.
53. Klein DJ, Aronson Friedman L, Harlan WR, et al.: Obesity and the development of insulin resistance and impaired fasting glucose in black and white adolescent girls: a longitudinal study. Diabetes Care 2004, 27: 378-383.
54. Haffner SM, D'Agostino R, Saad MF, et al.: Increased insulin resistance and insulin secretion in nondiabetic African-Americans and Hispanics compared with non-Hispanic whites. The Insulin Resistance Atherosclerosis Study. Diabetes 1996, 45: 742-748.
55. Osei K, Rhinesmith S, Gaillard T, Schuster D: Impaired insulin sensitivity, insulin secretion, and glucose effectiveness predict future development of impaired glucose tolerance and type 2 diabetes in pre-diabetic African Americans: implications for primary diabetes prevention. Diabetes Care 2004, 27: 1439-1446.
56. • Sumner AE, Cowie CC: Ethnic differences in the ability of triglyceride levels to identify insulin resistance. Atherosclerosis 2008, 196: 696-703 This evaluation of NHANES data among adults demonstrates that increasing TG levels are associated with increased insulin resistance among non-Hispanic blacks, although non-Hispanic blacks are likely to have TG levels in the "normal" range, even with significant insulin resistance.
57. Degawa-Yamauchi M, Dilts JR, Bovenkerk JE, et al.: Lower serum adiponectin levels in African-American boys. Obes Res 2003, 11: 1384-1390.
58. Lee S, Bacha F, Gungor N, Arslanian SA: Racial differences in adiponectin in youth: relationship to visceral fat and insulin sensitivity. Diabetes Care 2006, 29: 51-56.
59. Ford ES, Giles WH, Mokdad AH, Myers GL: Distribution and correlates of C-reactive protein concentrations among adult US women. Clin Chem 2004, 50: 574-581.
60. Ford ES, Giles WH, Myers GL, et al.: C-reactive protein concentration distribution among US children and young adults: findings from the National Health and Nutrition Examination Survey, 1999-2000. Clin Chem 2003, 49: 1353-1357.
61. Albert MA, Glynn RJ, Buring J, Ridker PM: C-reactive protein levels among women of various ethnic groups living in the United States (from the Women's Health Study). Am J Cardiol 2004, 93: 1238-1242.
62. Khera A, McGuire DK, Murphy SA, et al.: Race and gender differences in C-reactive protein levels. J Am Coll Cardiol 2005, 46: 464-469.
63. SEARCH for Diabetes in Youth Study Group; Liese AD, D'Agostino RB Jr, Hamman RF, et al.: The burden of diabetes mellitus among US youth: prevalence estimates from the SEARCH for Diabetes in Youth Study. Pediatrics 2006, 118: 1510-1518.
64. Cowie CC, Rust KF, Byrd-Holt DD, et al.: Prevalence of diabetes and impaired fasting glucose in adults in the U. S. population: National Health And Nutrition Examination Survey 1999-2002. Diabetes Care 2006, 29: 1263-1268.
65. Yancy CW, Benjamin EJ, Fabunmi RP, Bonow RO: Discovering the full spectrum of cardiovascular disease: Minority Health Summit 2003: executive summary. Circulation 2005, 111: 1339-1349.
66. Ogden CL, Carroll MD, Flegal KM: High body mass index for age among US children and adolescents, 2003-2006. JAMA 2008, 299: 2401-2405.
67. Lieb DC, Snow RE, DeBoer MD: Socioeconomic factors in the development of childhood obesity and diabetes. Clin Sports Med 2009, 28: 349-378.
68. Kimm SY, Barton BA, Obarzanek E, et al.: Racial divergence in adiposity during adolescence: The NHLBI Growth and Health Study. Pediatrics 2001, 107: E34.
69. Thompson DR, Obarzanek E, Franko DL, et al.: Childhood overweight and cardiovascular disease risk factors: the National Heart, Lung, and Blood Institute Growth and Health Study. J Pediatr 2007, 150: 18-25.
70. Hedley AA, Ogden CL, Johnson CL, et al.: Prevalence of overweight and obesity among US children, adolescents, and adults, 1999-2002. JAMA 2004, 291: 2847-2850.
71. Ogden CL, Carroll MD, Curtin LR, et al.: Prevalence of overweight and obesity in the United States, 1999-2004. JAMA 2006, 295: 1549-1555.
72. Ford ES, Giles WH, Dietz WH: Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey. JAMA 2002, 287: 356-359.
73. Katzmarzyk PT, Srinivasan SR, Chen W, et al.: Body mass index, waist circumference, and clustering of cardiovascular disease risk factors in a biracial sample of children and adolescents. Pediatrics 2004, 114: e198-e205.
74. Winkleby MA, Robinson TN, Sundquist J, Kraemer HC: Ethnic variation in cardiovascular disease risk factors among children and young adults: findings from the Third National Health and Nutrition Examination Survey, 1988-1994. JAMA 1999, 281: 1006-1013.
75. CDC: National Diabetes Fact Sheet: General Information and National Estimates on Diabetes in the United States, 2007. Atlanta, GA: U. S. Department of Health and Human Services, Centers for Disease Control and Prevention; 2008.
76. Sumner AE: "Half the dsylipidemia of insulin resistance" is the dsylipidemia of insulin-resistant Blacks. Ethn Dis 2009, 19: 462-465.
77. Butterworth SW: Influencing patient adherence to treatment guidelines. J Manag Care Pharm 2008, 14(6 Suppl B): 21-24.
78. Suarez M, Mullins S: Motivational interviewing and pediatric health behavior interventions. J Dev Behav Pediatr 2008, 29: 417-428.
79. Goetz T: 75 million Americans may have something called metabolic syndrome. How Big Pharma turned obesity into a disease-then invented the drugs to cure it. Wired 2006, 10: 152-157.
80. Zimmet P, Alberti G, Kaufman F, et al.: The metabolic syndrome in children and adolescents. Lancet 2007, 369: 2059-2061.
81. Andersen LB, Harro M, Sardinha LB, et al.: Physical activity and clustered cardiovascular risk in children: a cross-sectional study (The European Youth Heart Study). Lancet 2006, 368: 299-304.
82. Bao W, Srinivasan SR, Wattigney WA, Berenson GS: Persistence of multiple cardiovascular risk clustering related to syndrome X from childhood to young adulthood. The Bogalusa Heart Study. Arch Intern Med 1994, 154: 1842-1847.
83. Eisenmann JC: On the use of a continuous metabolic syndrome score in pediatric research. Cardiovasc Diabetol 2008, 7: 17.
84. Lee KK, Fortmann SP, Fair JM, et al.: Insulin resistance independently predicts the progression of coronary artery calcification. Am Heart J 2009, 157: 939-945.
85. Li C, Ford ES, Mokdad AH, Cook S: Recent trends in waist circumference and waist-height ratio among US children and adolescents. Pediatrics 2006, 118: e1390-e1398.