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A longitudinal study of serum insulin and insulin resistance as predictors of weight and body fat gain in African American and Caucasian children

International Journal of Obesity volume 41, pages 61–70 (2017)Cite this article

Subjects

Abstract

Background:

The influence of insulin and insulin resistance (IR) on children’s weight and fat gain is unclear.

Objective:

To evaluate insulin and IR as predictors of weight and body fat gain in children at high risk for adult obesity. We hypothesized that baseline IR would be positively associated with follow-up body mass index (BMI) and fat mass.

Subjects/Methods:

Two hundred and forty-nine healthy African American and Caucasian children aged 6–12 years at high risk for adult obesity because of early-onset childhood overweight and/or parental overweight were followed for up to 15 years with repeated BMI and fat mass measurements. We examined baseline serum insulin and homeostasis model of assessment-IR (HOMA-IR) as predictors of follow-up BMI Z-score and fat mass by dual-energy X-ray absorptiometry in mixed model longitudinal analyses accounting for baseline body composition, pubertal stage, sociodemographic factors and follow-up interval.

Results:

At baseline, 39% were obese (BMI⩾95th percentile for age/sex). Data from 1335 annual visits were examined. Children were followed for an average of 7.2±4.3 years, with a maximum follow-up of 15 years. After accounting for covariates, neither baseline insulin nor HOMA-IR was significantly associated with follow-up BMI (Ps>0.26), BMIz score (Ps>0.22), fat mass (Ps>0.78) or fat mass percentage (Ps>0.71). In all models, baseline BMI (P<0.0001), body fat mass (P<0.0001) and percentage of fat (P<0.001) were strong positive predictors for change in BMI and fat mass. In models restricted to children without obesity at baseline, some but not all models had significant interaction terms between body adiposity and insulinemia/HOMA-IR that suggested less gain in mass among those with greater insulin or IR. The opposite was found in some models restricted to children with obesity at baseline.

Conclusions:

In middle childhood, BMI and fat mass, but not insulin or IR, are strong predictors of children’s gains in BMI and fat mass during adolescence.

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Acknowledgements

This study received research support from Intramural Research Program, NIH, grant 1ZIAHD000641 (to JAY) from NICHD with supplemental funding from the National Institute for Minority Health and Health Disparities (NIMHD) and the Division of Nutrition Research Coordination (DNRC), NIH. NMS and AJK were supported by the Division of Nutrition Research Coordination and the National Institute of Diabetes and Digestive and Kidney Diseases. JAY is a Commissioned Officer in the US Public Health Service, Department of Health and Human Services. The funding organizations had no role in the design or conduct of the study; the collection, management, analysis, or interpretation of data; or the preparation of the manuscript.

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Authors and Affiliations

  1. Section on Growth and Obesity (SGO), Program in Developmental Endocrinology and Genetics (PDEGEN), Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, USA

    N M Sedaka, L E Yannai, W E Stutzman, A J Krause, R Sherafat-Kazemzadeh, T A Condarco, S M Brady, A P Demidowich, S Z Yanovski & J A Yanovski

  2. Biostatistics Consulting Center, Uniformed Services University of the Health Sciences, Bethesda, MD, USA

    C H Olsen

  3. Nuclear Medicine Department, Hatfield Clinical Research Center, NIH, Bethesda, MD, USA

    J C Reynolds

  4. Division of Digestive Diseases and Nutrition, Nutritional Sciences Branch, National Institute of Diabetes and Digestive and Kidney Diseases, NIH, Bethesda, MD, USA

    S Z Yanovski & V S Hubbard

  5. Division of Nutrition Research Coordination, NIH, Bethesda, MD, USA

    V S Hubbard

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  1. N M Sedaka
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  2. C H Olsen
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Correspondence to J A Yanovski.

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Author contributions

JAY, SZY and VSH conceived the experiment, NMS, LY, WS, AJK, RSK, TC, SMB, APD, APB, JCR and JAY carried out experiments, NMS, CO, JCR and JAY analyzed data. All authors were involved in writing the paper and had final approval of the submitted and published versions. The first draft of the manuscript was written by NMS and JAY.

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Sedaka, N., Olsen, C., Yannai, L. et al. A longitudinal study of serum insulin and insulin resistance as predictors of weight and body fat gain in African American and Caucasian children. Int J Obes 41, 61–70 (2017). https://doi.org/10.1038/ijo.2016.145

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