Published online October 2, 2006
PEDIATRICS Vol. 118 No. 5 November 2006, pp. e1516-e1522 (doi:10.1542/peds.2006-0845)
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ARTICLE

Hyperinsulinemia in Healthy Children and Adolescents With a Positive Family History for Type 2 Diabetes

Martha Rodríguez-Morán, MD, MSc, PhDa and Fernando Guerrero-Romero, MD, PhD, FACPb

a Medical Research Unit in Clinical Epidemiology of the Mexican Social Security Institute, Durango, Mexico
b Research Group on Diabetes and Chronic Illnesses, Durango, Mexico

OBJECTIVE. Our goal was to determine the relationship between family history of type 2 diabetes and fasting hyperinsulinemia in healthy children and adolescents.

METHODS. A total of 317 children and adolescents, 10 to 14 years of age with Tanner stage 1 or 2, were randomly selected from elementary and middle schools in Durango, northern Mexico, to participate in a cross-sectional, community-based study. Family history was ascertained by a direct, detailed medical examination that included anthropometric and laboratory measurements from both parents. We determined the prevalence of family history of type 2 diabetes, high blood pressure, obesity, hyperinsulinemia, and the adjusted odds ratio that computes the relationship between hyperinsulinemia and family history of type 2 diabetes.

RESULTS. Family history of type 2 diabetes, high blood pressure, and obesity was recognized in 30 (9.2%), 61 (18.7%), and 74 (22.7%) children and adolescents, respectively. Children and adolescents with positive family history showed higher systolic and diastolic blood pressure, were more obese, and exhibited significantly higher fasting insulin and triglycerides levels, as well as a higher homeostasis model analysis insulin resistance index, than children with negative family history. A total of 48 (15.1%) children and adolescents exhibited hyperinsulinemia, 35 (72.9%) with and 13 (27.1%) without family history. The odds ratio adjusted by gender, fat mass (kilograms and percent), waist circumference, BMI, and Tanner stage showed that family history of diabetes, but not high blood pressure and obesity, was independently related with hyperinsulinemia.

CONCLUSIONS. Among children and adolescents, family history of diabetes, but not high blood pressure and obesity, is independently associated with hyperinsulinemia.

Key Words: epidemiology • diabetes mellitus • family issues • obesity

Abbreviations: FH-D—family history of type 2 diabetes • HBP—high blood pressure • FH-HBP—family history of high blood pressure • FH-O—family history of obesity • HDL-C—high-density lipoprotein cholesterol • LDL-C—low-density lipoprotein cholesterol • HOMA-IR—homeostasis model analysis insulin resistance • CI—confidence interval • IGT—impaired glucose tolerance • OR—odds ratio

Accepted May 26, 2006.


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