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Grandparent Alert:Overweight Hispanic children shown to have
Vascular Inflammation
Newswise — Overweight Hispanic children with
normal blood glucose (sugar) levels showed
elevated markers for blood vessel
inflammation that may predispose them to
developing both type 2 diabetes and
cardiovascular disease, says a new study led
by researchers from the Joslin Diabetes
Center.
The study, published in the March issue of
Diabetes Care, is the first to focus
on Hispanic children, already known to be at
high risk for developing type 2 diabetes as
a result of both genetic and lifestyle
factors.
“Our findings suggest that these children
are not only at risk for type 2 diabetes,
but also for cardiovascular disease,” said
Dr. A. Enrique Caballero, lead investigator.
The study looked at 38 Hispanic children and
adolescents, ages 10 through 18.
Twenty-one were obese but with normal blood
glucose levels, so they had not yet
developed diabetes. The rest were considered
lean.
As a group, the obese subjects had
significantly higher percentages of body fat
than the lean group and were already showing
signs of insulin resistance, meaning the
insulin that their bodies produce is not
working well and as a consequence their
pancreases were being forced to work harder
to produce more insulin to maintain normal
blood sugar levels.
Overall, the obese group exhibited increased
blood markers for subclinical or
asymptomatic inflammation of the inner layer
of blood vessels.
“They are already
exhibiting problems with circulation,” said
Caballero, Director of the Latino Diabetes
Initiative, Clinical Investigator, Staff
Endocrinologist and Director, Medical
Affairs, Professional Education at Joslin
Diabetes Center, as well as an Assistant
Professor of Medicine at Harvard Medical
School. “There is an inflammatory process
going on in the vessels.”
Such problems suggest these children may be
at increased risk of developing
cardiovascular problems at a young age, he
said.
Subclinical vascular inflammation is a key
element in the development of cardiovascular
disease and is closely associated with
insulin resistance. It also predicts the
development of type 2 diabetes.
Earlier studies in overweight or obese
children and adolescents showed similar
vascular abnormalities, but were conducted
primarily in non-Hispanic children.
Caballero wanted to study Hispanic children
because they had not previously been studied
and because they are a high-risk population
for type 2 diabetes.
“We have found that overweight Hispanic
children and adolescents have elevated
markers of endothelial dysfunction and
vascular inflammation closely related to
excess body fat and increased insulin
resistance,” the paper concluded. “This. . .
may increase their risk of developing type 2
diabetes and cardiovascular disease, further
emphasizing the need for obesity prevention
strategies.”
Caballero said such strategies must be
culturally appropriate.
“Even if these abnormalities may not be that
different than those in Caucasian children,
the strategies to prevent heart disease and
diabetes need to be culturally oriented,’’
he said. “They need to be tailored to the
population.”
Caballero stressed that the findings do not
mean that such children will definitely
develop type 2 diabetes or cardiovascular
problems, but said the idea is to step in
early to make sure they don’t.
“The problem is serious enough to warrant
attention and a prevention strategy,” he
said.
The research was funded by a grant from
Sanofi Aventis and a National Institutes of
Health grant for general clinical research
at Beth Israel Deaconess Medical Center.
In addition to Dr. Caballero, other
researchers participating in the study
included: Dr. Ludivina Robles-Osorio,
Valeria Montagnani, RN, Dr. Geetha Soodini,
Dr. Sriurai Porramatikul, Dr. Osama Hamdy
and Dr. Edward S. Horton from the Joslin and
Kelb Bousquet-Santos and Dr. Antonio C.L.
Nobrega from Fluminense Federal University
in Brazil.
About the Latino Diabetes Initiative
The Latino Diabetes Initiative at Joslin Diabetes
Center, directed by Dr. Caballero, is a
comprehensive effort to improve the lives of
Latinos who have or are at risk of
developing diabetes.
This initiative integrates a culturally oriented
clinical care and patient education program,
community outreach activities, professional
education programs and a clinical research
program.
About Joslin Diabetes Center
Joslin Diabetes Center is the world’s largest
diabetes clinic, diabetes research center
and provider of diabetes education.
Joslin is dedicated to ensuring people with
diabetes live long, healthy lives and offers
real hope and progress toward diabetes
prevention and a cure for the disease.
Founded in 1898 by Elliott P. Joslin, M.D.,
Joslin is an independent nonprofit
institution affiliated with Harvard Medical
School. For more information on Joslin, call
1-800-JOSLIN-1 or visit
http://www.joslin.org.
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