Examination of the determinants of overweight and diabetes mellitus in US children
Overweight and type 2 diabetes are complex, multifactor chronic disorders that have increased at alarming rates in U.S. children and adolescents over the last two decades. The purpose of this study is to ascertain the determinants and predictors of overweight and type 2 diabetes in a nationally representative sample of U.S. children. Data from the 1999-2002 National Health and Nutrition Examination Survey (NHANES) were examined for 6,672 children stratified into age categories (5-12 years (n= 3,172);13-18 years (n= 3,500)) and 3 body mass index (BMI)-for-age categories (normal, at-risk for overweight and overweight). The same dataset was used to examine 3,813 children (12-18 years) stratified into males (51%) and females (49%) and 3 glucose categories (normoglycemic, pre-diabetes, and diabetes). Thirty-one percent of U.S. children are either at-risk for overweight or overweight with 16% presenting as overweight. These two groups of children had significantly greater measures of body adiposity than normal weight children with this weight being located throughout their bodies. Both overweight and at-risk for overweight children presented with significantly greater insulin levels than normal weight children resulting in an increased likelihood for the development of atherosclerosis and diabetes. Gender, age, poverty-income ratio, added sugar, waist, calf, arm and thigh circumference, tricep skinfold, systolic and diastolic blood pressure and HDL significantly predicted BMI-for-age percentiles, explaining 76% of the variance in BMI percentile. Data indicated that approximately 4% of U.S. children have pre-diabetes or diabetes. Children with pre-diabetes had significantly higher BMI percentiles than normoglycemic children and had significantly higher subscapular skinfold and BMI z-score measures. The levels of blood insulin were significantly higher in children with pre-diabetes and diabetes as compared to their normoglycemic counterparts and they had significantly higher glucose, uric acid, and glycohemoglobin values and significantly lower HDL values than normoglycemic children. Gender, waist circumference, total cholesterol, race, age and BMI percentile significantly predicted glycemic control, explaining 9% of the variance in glycated hemoglobin values. The epidemic of obesity in U.S. children is continuing to rise. Future research is needed to assess the impact of overweight and diabetes on this population and its progression toward the associated chronic complications.
School:The Ohio State University
School Location:USA - Ohio
Source Type:Master's Thesis
Keywords:diabetes overweight obesity children nhanes
Date of Publication:01/01/2005