Diabetes Status and Race are Associated With Cardiovascular Risk Markers in Obese Adolescents |
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| Institution: | 1. From the Division of Pediatric Endocrinology, Department of Pediatrics, University of Alabama School of Medicine, Birmingham, Alabama;2. Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama;3. Division of Pediatric Surgery, Department of Surgery, University of Alabama School of Medicine, Birmingham, Alabama;4. University of Alabama School of Medicine, Birmingham, Alabama;5. Ross University School of Medicine, Dominica, West Indies.;1. From the Division of Endocrinology and Diabetes, The Children’s Hospital of Philadelphia, Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania;2. From the Orthopaedic Trauma & Fracture Service, Hospital of the University of Pennsylvania Department of Orthopaedic Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania;3. From the Ralston-Penn Clinic for Osteoporosis & Related Bone Disorders, Center for FOP and Related Bone Disorders, Departments of Medicine & Orthopaedic Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.;1. Department of Pediatrics and Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA;2. Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA;3. Division of Pediatric Endocrinology and Diabetes, Stanford University, Stanford, CA, USA;4. Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver, Aurora, CO, USA;5. Division of Endocrinology, Cincinnati Children''s Hospital and Medical Center, Cincinnati, OH, USA;6. Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA;7. Sansum Diabetes Research Institute, Santa Barbara, CA, USA;1. From the Department of Otolaryngology - Head and Neck Surgery, Augusta, Georgia.;2. From the Department of Biostatistics and Epidemiology, Georgia Regents University, Augusta, Georgia.;1. Cardiovascular Division, Department of Medicine, Brigham and Women''s Hospital and Harvard Medical School, Boston, MA;2. Division of Nephrology, Health Sciences Center, St Johns, Newfoundland and Labrador, Canada;3. Faculdade de Medicina de São José, do Rio Preto, Brazil;4. Western Infirmary, University of Glasgow, Scotland, UK;5. Division of Nephrology, Tufts Medical Center, Boston, MA;6. Division of Nephrology/Hypertension, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL;7. Department of Nephrology and Hypertension, University of Erlangen-Nuremberg, Erlangen, Germany;8. Global Clinical Development, Amgen, Thousand Oaks, CA;9. Department of Medicine, University of Texas SW, Dallas, TX |
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| Abstract: | ObjectiveThe objective of this study was to evaluate differences in cardiovascular disease (CVD) risk markers in obese adolescents based on diabetes status and race in order to improve risk-reduction intervention strategies.MethodsThis was a retrospective, cross-sectional study of obese adolescents, age 10 to 21 years, who were evaluated at Children’s of Alabama between 2000 and 2012. Subjects were classified by glycated hemoglobin (HbA1c) as having normoglycemia, prediabetes, or type 2 diabetes mellitus (T2DM).ResultsThere were a total of 491 African American (AA) or Caucasian American (CA) subjects. Body mass index was not different between HbA1c and racial groups. Compared to subjects with normoglycemia or prediabetes, subjects with T2DM had higher levels of total cholesterol (TC) (178.6 ± 43.8 mg/dL vs. 161.5 ± 32.5 mg/dL vs. 162.4 ± 30.6 mg/dL; P < .0001) and low-density-lipoprotein cholesterol (107.4 ± 39.2 mg/dL vs. 97.0 ± 31.0 mg/dL vs. 97.5 ± 26.9 mg/dL; P = .0073). Compared with AA subjects, CA subjects had lower high-density-lipoprotein cholesterol (HDL-C) levels (40.4 ± 10.4 mg/dL vs. 44.3 ± 11.9 mg/dL; P = .0005) and higher non-HDL-C levels (129.6 ± 36.2 mg/dL vs. 122.5 ± 37.5 mg/dL; P = .0490). Of the characteristics studied, HbA1c had the most significant positive association with dyslipidemia and was strongly correlated with both TC (β, 4.21; P < .0001) and non-HDL-C (β, 4.3; P < .0001).ConclusionObese adolescents with T2DM have more abnormal lipoprotein profiles than those with normoglycemia or prediabetes. Obese CA adolescents have more abnormal lipids than obese AA adolescents. HbA1c was the characteristic most highly associated with abnormal lipoprotein profiles in our subjects. Our results show that CVD risk markers in obese adolescents vary by race and HbA1c concentration. (Endocr Pract. 2015;21:165-173) |
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