Magazine article Clinical Psychiatry News

Race Makes Difference in Metabolic Syndrome

Magazine article Clinical Psychiatry News

Race Makes Difference in Metabolic Syndrome

Article excerpt

ATLANTA -- There are no formal criteria defining metabolic syndrome in children, but it is clear that African American and white children show important differences in some of the components, Dr. Silva A. Arslanian said at the annual meeting of the International Society on Hypertension in Blacks.

A series of studies by Dr. Arslanian of the University of Pittsburgh and her colleagues has demonstrated that black children have lower insulin sensitivity and higher insulin secretion than do their white peers. Black children are more prone to fat accretion because of lower rates of lipolysis. And they have a limited capacity to increase insulin secretion in response to decreased insulin sensitivity.

Moreover, obese black adolescents are worse off than their white peers with respect to their diabetogenic risk profile, but better off with respect to their atherogenic risk profile.

Dr. Arslanian's research strategy is to recruit black and white children, match them on the basis of various demographic and physiologic factors, and admit them overnight to the children's research center one or more times for measurement of insulin secretion, insulin sensitivity, and other factors.

In one study, she compared 22 black with 22 white 10-year-olds with matching body mass indexes, fat composition, and visceral adipose tissue. Their average BMIs were about 18 kg/[m.sup.2], putting them well within the normal range. On their first admission, the investigators used a hyperinsulinemic/euglycemic clamp to assess in vivo insulin sensitivity. Three weeks later, the children were admitted again, this time for an assessment of insulin secretion with a hyperglycemic clamp.

Despite the fact that these children were identical to each other in all important metabolic ways, the white children had significantly higher insulin sensitivity than did the black children. One would expect that the black children would compensate for their lower insulin sensitivity by increasing insulin secretion, but that apparently did not happen.

The product of insulin sensitivity multiplied by first-phase insulin is known as the glucose disposition index (GDI), and in most populations the GDI is constant. …

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