Department ofMedicine, Johns Hopkins School ofMedicine, Baltimore, MD, USA.
Diabetes Care. 2013 Feb;36(2):436-42. doi: 10.2337/dc12-0828. Epub 2012 Oct 23.
Although African American adolescents have the highest prevalence of obesity, they have the lowest prevalence of metabolic syndrome across all definitions used in previous research. To address this paradox, we sought to develop a model of the metabolic syndrome specific to African American adolescents.
Data from the National Health and Nutrition Examination Survey (2003-2010) of 822 nonpregnant, nondiabetic, African American adolescents (45% girls; aged 12 to 17 years) who underwent physical examinations and fasted at least 8 h were analyzed. We conducted a confirmatory factor analysis to model metabolic syndrome and then used latent profile analysis to identify metabolic syndrome risk groups among African American adolescents. We compared the risk groups on probability of prediabetes.
The best-fitting metabolic syndrome model consisted of waist circumference, fasting insulin, HDL, and systolic blood pressure. We identified three metabolic syndrome risk groups: low, moderate, and high risk (19% boys; 16% girls). Thirty-five percent of both boys and girls in the high-risk groups had prediabetes, a significantly higher prevalence compared with boys and girls in the low-risk groups. Among adolescents with BMI higher than the 85th percentile, 48 and 36% of boys and girls, respectively, were in the high-risk group.
Our findings provide a plausible model of the metabolic syndrome specific to African American adolescents. Based on this model, approximately 19 and 16% of African American boys and girls, respectively, are at high risk for having the metabolic syndrome.
尽管非裔美国青少年的肥胖患病率最高,但在之前研究中使用的所有定义中,他们的代谢综合征患病率最低。为了解决这一矛盾,我们试图为非裔美国青少年建立一种特定的代谢综合征模型。
对参加了 2003-2010 年全国健康和营养检查调查(NHANES)的 822 名非妊娠、非糖尿病的非裔美国青少年(45%为女性;年龄 12-17 岁)的数据进行了分析,这些青少年接受了体检并禁食至少 8 小时。我们进行了验证性因子分析来建立代谢综合征模型,然后使用潜在剖面分析来识别非裔美国青少年的代谢综合征风险组。我们比较了风险组发生前驱糖尿病的概率。
拟合度最好的代谢综合征模型由腰围、空腹胰岛素、高密度脂蛋白和收缩压组成。我们确定了三个代谢综合征风险组:低风险、中风险和高风险(19%为男性;16%为女性)。高风险组中男女青少年有 35%患有前驱糖尿病,明显高于低风险组的青少年。在 BMI 高于第 85 百分位的青少年中,分别有 48%和 36%的男孩和女孩处于高风险组。
我们的研究结果为非裔美国青少年提供了一种合理的代谢综合征模型。根据该模型,大约 19%和 16%的非裔美国男孩和女孩分别处于代谢综合征高风险状态。