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Diabetes Care 28:2519-2524, 2005
© 2005 by the American Diabetes Association, Inc.

Metabolic Syndrome/Insulin Resistance Syndrome/Pre-Diabetes
Original Article

Decreased ß-Cell Function in Overweight Latino Children With Impaired Fasting Glucose

Marc J. Weigensberg, MD1, Geoff D.C. Ball, PHD2, Gabriel Q. Shaibi, BA2, Martha L. Cruz, PHD2 and Michael I. Goran, PHD2,3

1 Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, California
2 Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
3 Department of Physiology and Biophysics, Keck School of Medicine, University of Southern California, Los Angeles, California

Address correspondence and reprint requests to Michael I. Goran, PhD, 1540 Alcazar St., Room 208-D, Department of Preventive Medicine, University of Southern California, Los Angeles, California 90033. E-mail: goran{at}usc.edu

OBJECTIVE—To determine whether overweight Latino children with impaired fasting glucose (IFG) (≥100 mg/dl) have increased insulin resistance or decreased ß-cell function compared with those with normal fasting glucose (NFG).

RESEARCH DESIGN AND METHODS—We studied 207 healthy overweight Latino children, aged 8–13 years, with a family history of type 2 diabetes. Fasting and 2-h glucose and insulin were assessed by oral glucose tolerance test. Insulin sensitivity (Si), the acute insulin response to glucose (AIRg), and the disposition index (DI; an index of ß-cell function) were determined using the insulin-modified intravenous glucose tolerance test and minimal modeling. Body composition was determined by dual-energy X-ray absorptiometry.

RESULTS—There were no differences in body composition between NFG (n = 182) and IFG (n = 25) children. Compared with children with NFG, children with IFG had higher fasting and 2-h glucose values and higher fasting insulin. After adjusting for covariates, children with IFG had no difference in Si but 15% lower DI than NFG children (2,224 ± 210 vs. 2,613 ± 76, P < 0.05). Multivariate linear regression showed that AIRg and DI, but not Si, were significant predictors of fasting blood glucose.

CONCLUSIONS—In overweight Latino adolescents with a family history of type 2 diabetes, IFG is associated with impaired ß-cell function and therefore may identify children likely to be at risk for progression to type 2 diabetes. The actual risk of progression of IFG to type 2 diabetes remains to be determined by prospective longitudinal studies.

Abbreviations: ADA, American Diabetes Association • AIRg, acute insulin response to glucose • DI, disposition index • HOMA-IR, homeostasis model assessment of insulin resistance • IFG, impaired fasting glucose • IGT, impaired glucose tolerance • NFG, normal fasting glucose • USC, University of Southern California


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