Differential impact of impaired fasting glucose versus impaired glucose tolerance on cardiometabolic risk factors in multi-ethnic overweight/obese children

Abstract

We aimed to investigate the prevalence of impaired fasting glucose (IFG) and impaired glucose tolerance (IGT), and their associations with cardiometabolic risk factors, according to ethnicity in a large obese paediatric cohort. A 75-g oral glucose tolerance test was performed in 1,007 overweight/obese Dutch children of multi-ethnic origin, referred to the obesity outpatient clinics of two Dutch hospitals in Amsterdam (mean age, 11.4 ± 3.2 years; 50.7% boys). Anthropometric parameters and blood samples were collected, and cardiometabolic risk factors were assessed. The cohort consisted of Dutch native (26.0%), Turkish (23.7%), Moroccan (18.8%) and children of 'other' (31.5%) ethnicity. The prevalence of IFG was significantly higher in Moroccan and Turkish children as compared to Dutch native children (25.4% and 19.7% vs. 11.8%, respectively, P < 0.05). IGT was most frequently present in Turkish and Dutch native children, relative to Moroccan children (6.3% and 5.3% vs. 1.6%, P < 0.05). Besides pubertal status and ethnicity, components of 'metabolic syndrome' (MetS) which were associated with IGT, independent of hyperinsulinaemia, were hypertension [odds ratio (OR), 2.3; 95% CI, 1.1-4.9] while a trend was seen for high triglycerides (OR, 2.0; 95% CI, 0.9-4.3). When analyzing components of MetS which were associated with IFG, only low high-density lipoprotein cholesterol was significantly associated (OR, 1.7; 95% CI, 1.2-2.5) independent of hyperinsulinaemia. In conclusion, in a Dutch multi-ethnic cohort of overweight/obese children, a high prevalence of IFG was found against a low prevalence of IGT, which differed in their associations with cardiometabolic risk factors.

Fig. 1

Prevalence of impaired fasting glucose, impaired glucose tolerance, metabolic syndrome, hypertension, low HDL cholesterol, high triglycerides, high LDL cholesterol, high ALT according to ethnicity; Dutch native (white bars), Turkish (light grey bars) and Moroccan (dark grey bars). (Asterisk) P < 0.05, (infinity) N = 657

Fig. 2

Prevalence of the metabolic syndrome, hypertension, low HDL cholesterol, high triglycerides and high ALT according to glucometabolic status; normal glucose tolerance (white bars), impaired fasting glucose (light grey bars), impaired glucose tolerance (dark grey bars) or presence of both (black bars). *P < 0.05, ^∞ N = 657