@article{pmid18206684,

title = {Examining metabolic syndrome definitions in overweight Hispanic youth: a focus on insulin resistance},

author = {G Q Shaibi and M I Goran},

year  = {2008},

date = {2008-02-01},

journal = {J. Pediatr.},

volume = {152},

number = {2},

pages = {171--176},

abstract = {To examine the prevalence of the metabolic syndrome in overweight Hispanic youth according to 3 published pediatric definitions. Furthermore, the relationship of each definition to directly measured insulin resistance was examined. We conducted a secondary data analysis of 218 overweight Hispanic youth with a family history of type 2 diabetes mellitus. The metabolic syndrome was defined as >/=3 of these criteria: elevated triglyceride level, low high-density lipoprotein cholesterol level, elevated blood pressure, abdominal obesity, and hyperglycemia. The cutoff points were derived from updated definitions of Cook et al,(1) Cruz et al,(2) and Weiss et al.(3) Insulin sensitivity was determined with the insulin-modified frequently sampled intravenous glucose tolerance test. Prevalence of the metabolic syndrome ranged from 25.7% to 39%, with moderate to substantial agreement between definitions (kappa = 0.52-0.70). Regardless of definition, an inverse relationship between metabolic risk and insulin sensitivity was noted such that children with the metabolic syndrome had 51% to 60% lower insulin sensitivity compared with children without any risk factors (P or = 85th percentile for age and gender) from four elementary schools in Los Angeles County, California. In the total sample, boys and normal weight students had higher levels of total PA (counts per minute, cpm; p<0.05). Boys spent less time in sedentary PA (p=0.02) and more time in combined moderate to vigorous PA (MVPA},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid19023773,

title = {Reducing sedentary behavior in minority girls via a theory-based, tailored classroom media intervention},

author = {D Spruijt-Metz and S T Nguyen-Michel and M I Goran and C P Chou and T T Huang},

year  = {2008},

date = {2008-01-01},

journal = {Int J Pediatr Obes},

volume = {3},

number = {4},

pages = {240--248},

abstract = {To develop, implement and test an innovative, theory-based classroom media intervention known as Get Moving! to increase physical activity and decrease sedentary behaviors in predominantly Latina middle school girls. School-based intervention on five to seven consecutive school days in seven schools (four intervention and three control) with high Latino populations (above 60%). Intervention schools were matched to control schools by ethnic makeup and socioeconomic status (SES). Measures conducted 3 months before and 3 months after intervention included height, weight, percentage body fat (bioimpedance analysis), physical activity and psychosocial aspects of activity by questionnaire. Subjects were middle school girls, mean age 12.5 years old, 73% Latina (N=459 girls). Get Moving! significantly reduced time spent on sedentary behavior (beta+/- standard error},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid18619396,

title = {The collaboration readiness of transdisciplinary research teams and centers findings from the National Cancer Institute's TREC Year-One evaluation study},

author = {K L Hall and D Stokols and R P Moser and B K Taylor and M D Thornquist and L C Nebeling and C C Ehret and M J Barnett and A McTiernan and N A Berger and M I Goran and R W Jeffery},

year  = {2008},

date = {2008-00-01},

journal = {Am J Prev Med},

volume = {35},

number = {2 Suppl},

pages = {S161--172},

abstract = {Growing interest in promoting cross-disciplinary collaboration among health scientists has prompted several federal agencies, including the NIH, to establish large, multicenter initiatives intended to foster collaborative research and training. In order to assess whether these initiatives are effective in promoting scientific collaboration that ultimately results in public health improvements, it is necessary to develop new strategies for evaluating research processes and products as well as the longer-term societal outcomes associated with these programs. Ideally, evaluative measures should be administered over the entire course of large initiatives, including their near-term and later phases. The present study focuses on the development of new tools for assessing the readiness for collaboration among health scientists at the outset (during the first year) of their participation in the National Cancer Institute's Transdisciplinary Research on Energetics and Cancer (TREC) initiative. Indexes of collaborative readiness, along with additional measures of near-term collaborative processes, were administered as part of the TREC Year-One evaluation survey. Additionally, early progress toward scientific collaboration and integration was assessed, using a protocol for evaluating written research products. Results from the Year-One survey and the ratings of written products provide evidence of cross-disciplinary collaboration among participants during the first year of the initiative, and also reveal opportunities for enhancing collaborative processes and outcomes during subsequent phases of the project. The implications of these findings for future evaluations of team science initiatives are discussed.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid18656576,

title = {Dietary intake and the metabolic syndrome in overweight Latino children},

author = {E E Ventura and J N Davis and K E Alexander and G Q Shaibi and W Lee and C E Byrd-Williams and C M Toledo-Corral and C J Lane and L A Kelly and M J Weigensberg and M I Goran},

year  = {2008},

date = {2008-00-01},

journal = {J Am Diet Assoc},

volume = {108},

number = {8},

pages = {1355--1359},

abstract = {Little is known about the relationship between diet and metabolic health in Latino children, a population at increased risk for diabetes. The present study evaluates diet composition and the metabolic syndrome in a cross-sectional sample of 109 overweight Latino children aged 10 to 17 years with a family history of type 2 diabetes. Dietary intake was assessed by two 24-hour recalls. Associations between nutrients and features of the metabolic syndrome were examined using multiple linear regression and analysis of covariance. Log cholesterol intake was positively associated with log systolic blood pressure (beta=0.034},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid18563679,

title = {Adiponectin and leptin are independently associated with insulin sensitivity, but not with insulin secretion or beta-cell function in overweight Hispanic adolescents},

author = {C Koebnick and C K Roberts and G Q Shaibi and L A Kelly and C J Lane and C M Toledo-Corral and J N Davis and E E Ventura and K Alexander and M J Weigensberg and M I Goran},

year  = {2008},

date = {2008-00-01},

journal = {Horm. Metab. Res.},

volume = {40},

number = {10},

pages = {708--712},

abstract = {The aim of the study was to investigate the independent effects of leptin and adiponectin on insulin sensitivity as well as insulin secretion and beta-cell function in overweight Hispanic adolescents. Despite pubertal changes in hormone secretion, studies investigating the independent effect of both hormones on insulin sensitivity and beta-cell function in adolescents are lacking. In a cross-sectional study, 175 overweight Hispanic adolescent boys (n=101) and girls (n=74) with a family history of diabetes were recruited and insulin sensitivity (SI), acute insulin response to glucose (AIR), disposition index (DI), body composition, total serum adiponectin, and leptin were assessed. Over age, leptin significantly increased in girls but not in boys (p for age x gender interaction=0.005) while adiponectin was similar in boys and girls. Leptin was not correlated to adiponectin. Leptin (partial r=-0.180; p=0.019) and adiponectin (partial r=0.230; p=0.003) predicted SI independent of age, gender, body fat, lean body mass, and Tanner stage but together, they explained 5% of the unique variation in SI (p for R (2)-change<0.001). Leptin or adiponectin were not related to AIR or DI. With regard to SI, AIR, and DI, no significant gender, age, or Tanner stage interactions were observed suggesting similar effects of adiponectin and leptin among gender, age, and Tanner stages. Leptin and adiponectin were independently associated with SI, but not with insulin secretion or beta-cell function.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid18503498,

title = {Cardiorespiratory fitness and physical activity in youth with type 2 diabetes},

author = {G Q Shaibi and M S Faulkner and M J Weigensberg and C Fritschi and M I Goran},

year  = {2008},

date = {2008-00-01},

journal = {Pediatr Diabetes},

volume = {9},

number = {5},

pages = {460--463},

abstract = {The increased incidence of type 2 diabetes (T2D) among youth is hypothesized to be due, in part, to low levels of fitness and activity. Therefore, the purpose of this investigation was to examine whether cardiorespiratory fitness and physical activity are reduced in youth with T2D compared with overweight controls. Thirteen adolescent boys with previously diagnosed T2D (mean duration 2.4 +/- 1.8 yr) were matched for age and body mass index to 13 overweight, non-diabetic controls. Cardiorespiratory fitness was assessed during a progressive exercise test to volitional fatigue and physical activity was estimated from a 7-d physical activity recall. Youth with T2D reported performing approximately 60% less moderate to vigorous physical activity compared with their non-diabetic counterparts (0.6 +/- 0.2 vs. 1.4 +/- 0.3 h/d},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid18252788,

title = {Association between the metabolic syndrome and serum cortisol in overweight Latino youth},

author = {M J Weigensberg and C M Toledo-Corral and M I Goran},

year  = {2008},

date = {2008-00-01},

journal = {J. Clin. Endocrinol. Metab.},

volume = {93},

number = {4},

pages = {1372--1378},

abstract = {The purpose of this report is to investigate the associations between metabolic syndrome (MS) and levels of morning serum cortisol in a cohort of overweight Latino youth. Subjects were 205 overweight, Latino youth (age 8-13 yr, body mass index percentile > 85, family history positive for type 2 diabetes). Measures included body composition by dual-energy x-ray absorptiometry, intraabdominal adipose tissue (IAAT) by magnetic resonance imaging, insulin sensitivity by frequently sampled iv glucose tolerance test/minimal model, fasting lipids, and serum cortisol. Children with MS had higher body mass index percentile, total body fat mass, and IAAT and lower insulin sensitivity than those without MS. Children with MS had higher morning serum cortisol levels, whether unadjusted (10.1 +/- 3.7 vs. 9.0 +/- 2.8 microg/dl, P < 0.05) or after adjusting for age, gender, total body fat and lean tissue mass, and insulin sensitivity (10.4 +/- 0.4 vs. 8.9 +/- 0.3 microg/dl, P < 0.01). Increasing number of features of MS was associated with higher cortisol levels, after adjusting for covariates (P = 0.001). Among individual features of MS, systolic blood pressure had the strongest relationship with adjusted cortisol level (r = 0.34; P < 0.001), followed by diastolic blood pressure and fasting plasma glucose (both r = 0.23; P < 0.01). IAAT was associated with cortisol (r = 0.16; P < 0.05), whereas high-density lipoprotein, triglycerides, and waist circumference were not. In overweight, Latino youth, MS is associated with higher morning serum cortisol levels, independent of body fat and insulin sensitivity. More studies are needed to investigate the role of relative hypercortisolism and chronic stress in obesity-related metabolic disorders in children.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid17991643,

title = {Associations of dietary sugar and glycemic index with adiposity and insulin dynamics in overweight Latino youth},

author = {J N Davis and K E Alexander and E E Ventura and L A Kelly and C J Lane and C E Byrd-Williams and C M Toledo-Corral and C K Roberts and D Spruijt-Metz and M J Weigensberg and M I Goran},

year  = {2007},

date = {2007-11-01},

journal = {Am. J. Clin. Nutr.},

volume = {86},

number = {5},

pages = {1331--1338},

abstract = {Few studies have examined the relation between dietary carbohydrate quality, adiposity, and insulin dynamics in children. The objective of the study was to determine which aspects of dietary carbohydrate, specifically dietary sugar, fiber, glycemic index, or glycemic load, are associated with adiposity and insulin dynamics in overweight Latino children. We examined 120 overweight Latino children (10-17 y old) with a family history of type 2 diabetes. Dietary intake was determined by repeated 24-h diet recalls. Adiposity was assessed by using total-body dual-energy X-ray absorptiometry. Insulin dynamics [insulin sensitivity (SI), acute insulin response, and disposition index (an index of beta-cell function)] were measured by using a frequently sampled intravenous-glucose-tolerance test. After adjustment for covariates, total sugar (g/d) was positively correlated with body mass index (BMI; in kg/m(2)), BMI z scores, and total fat mass (r = 0.20},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid17763019,

title = {Frequency of hypoglycaemia during the intravenous glucose tolerance test in overweight childre},

author = {M L Cruz and M J Weigensberg and R N Bergman and M I Goran},

doi = {10.1080/17477160601181589},

year  = {2007},

date = {2007-07-10},

journal = {Int J Pediatr Obes.},

volume = {2},

number = {2},

pages = {122-5},

abstract = {The study aimed to assess the frequency of hypoglycaemia during the insulin-modified, frequently sampled intravenous glucose tolerance test (FSIVGTT) in overweight Hispanic children. The study included 210 children, mean age=11+/-1.7 years, BMI percentile=97.2+/-2.9 who where enrolled in a longitudinal study to explore risk factors for type 2 diabetes. Two fasting blood samples were collected to determine basal glucose and insulin concentrations. At time 0, glucose (0.3 g/kg body weight) was administered intravenously. Eleven blood samples were collected until 180 min post glucose injection. Insulin (0.02 U/kg body weight) was injected intravenously at 20 min. Plasma was analyzed for glucose and insulin and used for the determination of insulin sensitivity. Hypoglycaemia, defined as a plasma glucose<50 mg/dl, was observed in one asymptomatic subject (<0.5% subjects). In addition, only 1.9% of subjects (n=4) had plasma glucose<60 mg/dl at any time during the FSIVGTT. The frequency of hypoglycaemia during the insulin modified FSIVGTT is very low in overweight Hispanic youth.},

keywords = {glucose},

pubstate = {published},

tppubtype = {article}

}

@article{pmid17763007,

title = {Feasibility of a home-based versus classroom-based nutrition intervention to reduce obesity and type 2 diabetes in Latino youth},

author = {J N Davis and E E Ventura and K E Alexander and L E Salguero and M J Weigensberg and N C Crespo and D Spruijt-Metz and M I Goran},

doi = {10.1080/17477160601133077},

year  = {2007},

date = {2007-07-10},

journal = {Int J Pediatr Obes.},

volume = {2},

number = {1},

pages = {22-30},

abstract = {Objectives: The objectives of this pilot study were to compare the dietary, physiological and metabolic effects of 12-week modified carbohydrate nutrition intervention when disseminated in an individualized home-based format versus a group classroom-based format.



Methods: Twenty-three overweight (>/=85(th) percentile BMI) Latina adolescent females (12-17 years of age) were randomized to a 12-week modified carbohydrate dietary intervention delivered in either an individualized home-based format (n = 11) or a group classroom-based format (n = 12). Anthropometrics, dietary intake by 3-day diet records, insulin dynamics by extended 3-hour Oral Glucose Tolerance test (OGTT) and body composition by Dual energy X-ray absorptiometry (DXA) were measured before and after intervention; 24-hour diet recalls were collected once or twice per month throughout the program.



Results: Mixed modeling showed no significant differences in changes in dietary intake between intervention groups, but both groups significantly reduced intake of added sugar, sugary beverages and refined carbohydrates by 33%, 66%, and 35%, respectively, and dietary fiber significantly increased by 44% (p <0.01) throughout the 12 weeks. There was a significant time effect for BMI z-scores within each intervention group (p <0.05). There was no significant time*intervention group interaction for any of the physiological or metabolic variables, indicating that change over time was not significantly different between intervention groups.



Conclusions: Although a culturally tailored, modified carbohydrate dietary intervention led to significant improvements in dietary intake and BMI z-scores, the extremely intensive, individualized, home-based program was no more effective at improving diet, decreasing adiposity or reducing type 2 diabetes risk factors than the traditional classroom-based format.},

keywords = {latino},

pubstate = {published},

tppubtype = {article}

}

@article{pmid18370826,

title = {Reduction in added sugar intake and improvement in insulin secretion in overweight latina adolescents},

author = {J N Davis and E E Ventura and G Q Shaibi and M J Weigensberg and D Spruijt-Metz and R M Watanabe and M I Goran},

year  = {2007},

date = {2007-06-01},

journal = {Metab Syndr Relat Disord},

volume = {5},

number = {2},

pages = {183--193},

abstract = {To date, no study has assessed the effects of modifying carbohydrate intake (specifically decreasing added sugar and increasing fiber) on insulin secretion, nor has any study used an overweight Latino adolescent population. The objective of this study was to examine whether changes in dietary intake, specifically reductions in added sugar and/or increases in fiber, following a 12-week, modified carbohydrate dietary intervention, were associated with changes in insulin secretion and other metabolic risk factors for type 2 diabetes. Participants were 16 overweight (>/=85th percentile BMI) Latina adolescent females (12-17 years) who completed a 12-week modified carbohydrate intervention. Dietary intake was assessed by 3-day diet records, body composition by dual-energy X-ray absorptiometry, and insulin dynamics by an extended 3-hour oral glucose tolerance test (OGTT) at baseline and postintervention. There was a trend for unadjusted change in reported added sugar intake (% of kcals) to be associated with change in insulin secretion, i.e. IAUC (r = 0.47; p = 0.075), and this relationship became significant after controlling for age, baseline insulin secretion, added sugar and adiposity, and change in adiposity (r = 0.85; p < 0.05). No other changes in dietary variables were related to changes in insulin secretion or other metabolic risk factors for type 2 diabetes. Participants with greater reductions in added sugar intake showed significantly greater improvements in insulin secretion following a modified carbohydrate nutrition intervention. These findings suggest that interventions focused on decreasing added sugar intake have the potential to reduce type 2 diabetes risk in overweight youth.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid17311859,

title = {Adiponectin independently predicts metabolic syndrome in overweight Latino youth},

author = {G Q Shaibi and M L Cruz and M J Weigensberg and C M Toledo-Corral and C J Lane and L A Kelly and J N Davis and C Koebnick and E E Ventura and C K Roberts and M I Goran},

year  = {2007},

date = {2007-05-01},

journal = {J. Clin. Endocrinol. Metab.},

volume = {92},

number = {5},

pages = {1809--1813},

abstract = {Adiponectin may be important in the pathogenesis of insulin resistance and the metabolic syndrome in youth. The objective of the study was to determine the unique effect of adiponectin on the metabolic syndrome in overweight Latino youth. Participants included 175 overweight children (aged 11.1 +/- 1.7 yr, body mass index percentile 97.3 +/- 2.9) with a family history of type 2 diabetes. Metabolic syndrome was defined according to a pediatric adaptation of the Adult Treatment Panel III report and included dyslipidemia, abdominal obesity, elevated blood pressure, and prediabetes (impaired fasting glucose or impaired glucose tolerance from a 2-h oral glucose tolerance test). Body composition was estimated via dual-energy x-ray absorptiometry, insulin sensitivity was quantified by the frequently sampled iv glucose tolerance test, visceral fat was measured using magnetic resonance imaging, and adiponectin was determined in fasting serum. In simple linear regression, adiponectin was significantly and inversely related to systolic blood pressure (P < 0.05), waist circumference (P < 0.001), triglycerides (P < 0.001), and 2-h glucose levels (P < 0.05) and positively related to high-density lipoprotein-cholesterol (P < 0.001). In multiple linear regression, adiponectin was significantly related to triglycerides (P < 0.01) and high-density lipoprotein-cholesterol (P < 0.01) independent of age, gender, Tanner stage, body composition, and insulin sensitivity. Analyses of covariance established that adiponectin levels were approximately 25% higher in healthy overweight youth, compared with those with the metabolic syndrome (12.5 +/- 3.5 vs. 9.4 +/- 2.8 microg/ml; P < 0.05). In multiple logistic regression, adiponectin was a significant independent predictor of the metabolic syndrome, even after adjustment for confounders including insulin sensitivity and visceral fat. Hypoadiponectinemia is an independent biomarker of the metabolic syndrome, and thus, adiponectin may play a role in the pathophysiology of the disorder in overweight youth.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid17372328,

title = {Developmental trajectories of overweight during childhood: role of early life factors},

author = {C Li and M I Goran and H Kaur and N Nollen and J S Ahluwalia},

year  = {2007},

date = {2007-03-01},

journal = {Obesity (Silver Spring)},

volume = {15},

number = {3},

pages = {760--771},

abstract = {Our goal was to identify developmental trajectories of overweight in children and to assess early life influences on these trajectories. Participants consisted of 1739 white, black, and Hispanic children who were younger than 2 years at the first survey and were followed up to 12 years of age. Repeated measures of overweight, defined as BMI > or = 95th percentile, were used to identify overweight trajectories with a latent growth mixture modeling approach. Three distinct overweight trajectories were identified: 1) early onset overweight (10.9%), 2) late onset overweight (5.2%), and 3) never overweight (83.9%). After adjustment for multiple potential risk factors, male gender [odds ratio (OR), 1.5; 95% confidence interval (CI), 1.0 to 2.2], black ethnicity (OR, 1.7; 95% CI, 1.1 to 2.6), maternal 25 < or = BMI < 30 kg/m2 (OR, 2.2; 95% CI, 1.3 to 3.7) or > or = 30 kg/m2 (OR, 5.1; 95% CI, 2.9 to 9.1), maternal weight gain during pregnancy > or = 20.43 kg (OR, 1.7; 95% CI, 1.0 to 2.9), and birth weight > or = 4000 g (OR, 2.0; 95% CI, 1.2 to 3.4) were associated with an increased risk of early onset overweight. These risk factors, except maternal weight gain, exerted similar effects on late onset overweight. In addition, maternal smoking (OR, 1.6; 95% CI, 0.8 to 3.1) and birth order > or = 3 (OR, 2.3; 95% CI, 1.0 to 5.2) were associated with an increased risk of late onset overweight only. Breastfeeding > or = 4 months was associated with a decreased risk of both early (OR, 0.7; 95% CI, 0.3 to 1.3) and late onset overweight (OR, 0.7; 95% CI, 0.3 to 1.7). Two trajectories of overweight and one never overweight group were identified. Early life predictors may have a significant influence on the developmental trajectories of overweight in children.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid17261466,

title = {Lower bone mineral content in hypertensive compared with normotensive overweight Latino children and adolescents},

author = {A Afghani and M I Goran},

year  = {2007},

date = {2007-02-01},

volume = {20},

number = {2},

pages = {190--196},

abstract = {In adults, hypertension has been shown to be inversely correlated with bone mineral content (BMC); however, the association between blood pressure (BP) and BMC has not been studied in pediatrics. Total body BMC of 187 overweight (mean BMI = 28.7 kg/m(2)) Latino children and adolescents (mean age = 11.2 years) were measured using dual-energy x-ray absorptiometry. Seated systolic BP (SBP) and diastolic BP (DBP) were measured using a standard mercury sphygmomanometer. Hypertension was defined by SBP or DBP above the 90(th) percentile for height, age, and sex. Partial correlations revealed an inverse association between SBP and BMC (r = -0.24},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid17848833,

title = {Leptin-to-adiponectin ratio as independent predictor of insulin sensitivity during growth in overweight Hispanic youth},

author = {C Koebnick and G Q Shaibi and L A Kelly and C K Roberts and C J Lane and C Toledo-Corral and J N Davis and C Byrd-Williams and M J Weigensberg and M I Goran},

year  = {2007},

date = {2007-01-01},

journal = {J. Endocrinol. Invest.},

volume = {30},

number = {7},

pages = {C13--16},

abstract = {Because leptin and adiponectin are counter-regulated in vivo and exert opposing effects on glucose metabolism, fat oxidation and insulin sensitivity, the ratio of leptin-to-adiponectin has been investigated as a potential atherogenic index, suggesting that the index is a better biomarker for atherosclerotic risk in obese Type 2 diabetic patients than either leptin or adiponectin alone. However, no information is available regarding the leptin-to-adiponectin ratio during adolescence in Hispanic adolescents. Therefore, the present study was designed to investigate the leptin-to-adiponectin ratio during growth and to establish whether the leptin-to-adiponectin ratio is a better predictor for insulin sensitivity compared to leptin and adiponectin alone in a regression model. From the age of 8 to 14, the leptin-to-adiponectin ratio increased from 2.0+/-0.8 to 5.8+/-2.2 in girls, with no significant change noted in boys (gender x age interaction p=0.007). In a multiple regression analysis, including both adiponectin and leptin as independent variables, leptin and adiponectin explained 5% of the variation in insulin sensitivity independent of gender, age, Tanner stage, total fat mass and lean body mass (p for R2-change <0.001). The leptin-to-adiponectin ratio also explained 5% of the variation in insulin sensitivity, after controlling for the same covariates (p for R2-change <0.001). These data indicate that the leptin-to-adiponectin ratio is not a better predictor of insulin sensitivity during growth than the additive effects of leptin and adiponectin levels.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid17626894,

title = {Parental history and risk of type 2 diabetes in overweight Latino adolescents: a longitudinal analysis},

author = {L A Kelly and C J Lane and M J Weigensberg and C Koebnick and C K Roberts and J N Davis and C M Toledo-Corral and G Q Shaibi and M I Goran},

year  = {2007},

date = {2007-00-01},

journal = {Diabetes Care},

volume = {30},

number = {10},

pages = {2700--2705},

abstract = {The purpose of this article was to examine metabolic risk factors for type 2 diabetes in children and adolescents as a function of maternal versus paternal family history of type 2 diabetes and to examine whether differences in these risk factors emerge during adolescent growth. A total of 247 overweight Latino children (baseline age = 11.1 +/- 1.7 years) with a parental history of type 2 diabetes were followed annually for 5 years (2.2 +/- 1.2 observations/child) with measures of insulin sensitivity, acute insulin response to glucose, and disposition index. Longitudinal linear mixed-effects modeling was used to evaluate the influence of maternal versus paternal family history of type 2 diabetes on changes in diabetes risk factors over age. Insulin sensitivity and the disposition index decreased over age (beta = -0.052 and beta = -0.033, P < 0 0.01). Acute insulin response to glucose and fasting and 2-h glucose increased (beta = 0.019},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid17277039,

title = {Influence of breastfeeding on obesity and type 2 diabetes risk factors in Latino youth with a family history of type 2 diabetes},

author = {J N Davis and M J Weigensberg and G Q Shaibi and N C Crespo and L A Kelly and C J Lane and M I Goran},

year  = {2007},

date = {2007-00-01},

journal = {Diabetes Care},

volume = {30},

number = {4},

pages = {784--789},

abstract = {To determine whether breastfeeding is related to total adiposity, regional adiposity, and glucose and insulin dynamics in overweight Latino youth throughout puberty. The relation between breastfeeding and diabetes risk was determined in 240 overweight (BMI > or =85th percentile) Latino children (aged 8-13 years) with a positive family history of type 2 diabetes. Children were examined at baseline (Tanner pubertal stage 1) and for 2 more years as they advanced in pubertal maturation. Children were divided into the following categories: never breastfed (n = 102), breastfed 0-5.99 months (n = 61), breastfed 6-11.99 months (n = 24), and breastfed > or =12 months (n = 53). Tanner pubertal stage was determined by physical examination. Visceral and subcutaneous abdominal fat were determined by magnetic resonance imagining, and total body fat, total lean tissue mass, and percent body fat were measured by dual-energy X-ray absorptiometry. Fasting and postchallenge glucose were assessed with a 2-h oral glucose tolerance test. Insulin sensitivity (SI), acute insulin response (AIR), and disposition index ([DI] an index of beta-cell function) were measured by frequently sampled intravenous glucose tolerance test and minimal modeling. Data were analyzed using linear mixed-effects modeling. There were no significant effects of breastfeeding categories on adiposity (i.e., total fat mass, total lean tissue mass, percent body fat), fat distribution (visceral and subcutaneous abdominal fat), fasting glucose or 2-h glucose, or insulin dynamics (SI, AIR, and DI) at Tanner pubertal stage 1 or on changes in these variables over pubertal transitions in overweight Latino youth. In this population of high-risk Latino youth, there were no significant protective effects of breastfeeding on adiposity or type 2 diabetes risk factors at Tanner pubertal stage 1 or across advances in maturation.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid17115240,

title = {Racial differences in the association of subcutaneous and visceral fat on bone mineral content in prepubertal children},

author = {A Afghani and M I Goran},

year  = {2006},

date = {2006-12-01},

journal = {Calcif. Tissue Int.},

volume = {79},

number = {6},

pages = {383--388},

abstract = {Total fat mass plays a significant role in determining bone mass, but the specific role of central adiposity independent of total fat mass has not been widely studied. Prepubertal (Tanner 1) children (n = 181; 65 boys, 116 girls, 7.8 +/- 1.5 years), including 99 Caucasians and 82 African Americans from Birmingham, Alabama, participated in this study. Body composition, including total body and trunk fat mass, and bone mineral content (BMC) were measured using dual-energy X-ray absorptiometry. Subcutaneous abdominal adipose tissue (SAAT) and intra-abdominal adipose tissue (IAAT) were determined by single-slice computed tomography (CT). After adjusting for gender, age, height, total fat, and lean mass, trunk weight was inversely correlated with BMC in Caucasians (r = -0.56, P < 0.0001) and in African Americans (r = -0.37, P < 0.05). In Caucasians, independent of gender, age, height, total fat, and lean mass, there was an inverse correlation between SAAT and BMC (r = -0.58, P < 0.0001) but no significant correlation between IAAT and BMC; in addition, SAAT explained 6% of the variance in BMC. In contrast, in African Americans, SAAT and BMC were not significantly correlated. However, while adjusting for gender, age, height, SAAT, total fat, and lean mass, an inverse association between IAAT and BMC was observed in African Americans (r = -0.50, P < 0.01); IAAT also explained 3% of the variance in BMC. These findings suggest that, in general, total abdominal weight is negatively associated with bone mass, but there appear to be racial differences with regard to the contributions of subcutaneous and visceral fat to BMC in prepubertal children.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid17119061,

title = {Ethnic disparity in the relationship between obesity and plasma insulin-like growth factors: the multiethnic cohort},

author = {K D Henderson and M I Goran and L N Kolonel and B E Henderson and L Le Marchand},

year  = {2006},

date = {2006-11-01},

journal = {Cancer Epidemiol. Biomarkers Prev.},

volume = {15},

number = {11},

pages = {2298--2302},

abstract = {Previous studies on the relationship between obesity and circulating insulin-like growth factor (IGF) hormones show inconsistent findings and have not considered the possibility of racial/ethnic-specific differences that may exist. We therefore examined the relationship between obesity status [as measured by body mass index (BMI)] and plasma levels of the IGF proteins, IGF-I, IGF-binding protein 3 (IGFBP-3), and the molar ratio of IGF-I/IGFBP-3 in Whites, African Americans, Latinos, Japanese Americans, and Native Hawaiians from the ongoing Hawaii and Los Angeles Multiethnic Cohort Study. We measured plasma IGF-I and IGFBP-3 by ELISA in a random sample of 811 Multiethnic Cohort participants (53% male, age range = 47-82 at blood draw). In a multivariate regression of IGF-I levels, we found a statistically significant interaction between race/ethnicity and obesity status (P = 0.005). Plasma IGF-I levels declined with increasing BMI most dramatically in Latinos and Japanese. This decline was attenuated in Whites and absent in African-American and Native Hawaiian subjects. In Japanese, the quadratic term (BMI(2)) was statistically significant in a multivariate model (P = 0.002). In Latinos, the adjusted least-squares mean IGF-I levels in ng/mL for BMI < 25, 25 to 29.99, and >or=30 were 184.6, 147.7, and 132.7, respectively. No interaction between race/ethnicity and BMI explained the plasma IGFBP-3 levels in these data. These results may help to resolve the uncertainty in the relationship between circulating IGF levels and obesity and highlight the potential importance of racial/ethnic-specific effects among these factors in explaining ethnic disparities in obesity-related cancers.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid16826016,

title = {Effects of resistance training on insulin sensitivity in overweight Latino adolescent males},

author = {G Q Shaibi and M L Cruz and G D Ball and M J Weigensberg and G J Salem and N C Crespo and M I Goran},

year  = {2006},

date = {2006-07-01},

journal = {Med Sci Sports Exerc},

volume = {38},

number = {7},

pages = {1208--1215},

abstract = {Insulin resistance is thought to be a core defect in the pathophysiology of obesity-related comorbidities in children, such as type 2 diabetes. Exercise training is known to improve insulin resistance and reduce the risk of type 2 diabetes in adults. However, very little is known regarding the effects of exercise on insulin resistance in youth. Therefore, we examined the effects of a 16-wk resistance training exercise intervention on insulin sensitivity in youth at high risk for developing type 2 diabetes. Twenty-two overweight Latino adolescent males were randomly assigned to either a twice-per-week resistance training group (RT=11) or a nonexercising control group (C=11) for 16 wk. Strength was assessed by one-repetition maximum, body composition was quantified by dual-energy x-ray absorptiometry, and insulin sensitivity was determined by the frequently sampled intravenous glucose tolerance test with minimal modeling. Significant increases in upper- and lower-body strength were observed in the RT compared with the C group. The RT group significantly increased insulin sensitivity compared with the C group (P<0.05), and this increase remained significant after adjustment for changes in total fat mass and total lean tissue mass (P<0.05). Compared with baseline values, insulin sensitivity increased 45.1+/-7.3% in the RT group versus -0.9+/-12.9% in controls (P<0.01). A twice-per-week 16-wk resistance training program can significantly increase insulin sensitivity in overweight Latino adolescent males independent of changes in body composition.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid16753062,

title = {Validity of new child-specific thoracic gas volume prediction equations for air-displacement plethysmography},

author = {P B Higgins and A M Silva and L B Sardinha and H R Hull and M I Goran and B A Gower and D A Fields},

year  = {2006},

date = {2006-06-01},

journal = {BMC Pediatr},

volume = {6},

pages = {18},

abstract = {To determine the validity of the recently developed child-specific thoracic gas volume (TGV) prediction equations for use in air-displacement plethysmography (ADP) in diverse pediatric populations. Three distinct populations were studied: European American and African American children living in Birmingham, Alabama and European children living in Lisbon, Portugal. Each child completed a standard ADP testing protocol, including a measured TGV according to the manufactures software criteria. Measured TGV was compared to the predicted TGV from current adult-based ADP proprietary equations and to the recently developed child-specific TGV equations of Fields et al. Similarly, percent body fat, derived using the TGV prediction equations, was compared to percent body fat derived using measured TGV. Predicted TGV from adult-based equations was significantly different from measured TGV in girls from each of the three ethnic groups (P < 0.05), however child-specific TGV estimates did not significantly differ from measured TGV in any of the ethnic or gender groups. Percent body fat estimates using adult-derived and child-specific TGV estimates did not differ significantly from percent body fat measures using measured TGV in any of the groups. The child-specific TGV equations developed by Fields et al. provided a modest improvement over the adult-based TGV equations in an ethnically diverse group of children.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid16617311,

title = {Birth weight, puberty, and systolic blood pressure in children and adolescents: a longitudinal analysis},

author = {C Li and T K Huang and M L Cruz and M I Goran},

year  = {2006},

date = {2006-06-01},

journal = {J Hum Hypertens},

volume = {20},

number = {6},

pages = {444--450},

abstract = {We examined the association between birth weight and systolic blood pressure (SBP) from pre-puberty to late puberty in a cohort of American children. Ninety-eight children aged 4-12 years at baseline were followed annually for 2-6 years with at least two Tanner stages. Annual measures included SBP, age, gender, race, birth weight, Tanner stage, and body composition using dual-energy X-ray absorptiometry and computed tomography. Birth weight was inversely correlated with SBP in pre-pubertal children (r=-0.23, P<0.05), especially in white children. SBP persisted at a higher level from pre-puberty through late puberty among children with low birth weight (<2500 g). However, SBP significantly increased from pre-puberty to early or late puberty among children with high birth weight (>or=4000 g). After adjusting for visceral fat, one unit change of birth weight category was associated with a 2.6 mm Hg reduction in SBP (P<0.05), but this association was attenuated as puberty progressed. The changes in SBP across puberty followed different trajectories in children with low vs high birth weight. Attenuation in the association between birth weight and SBP from pre-puberty to late puberty may be influenced by sexual maturation.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid25197163,

title = {Acculturation is Associated With Ħigher VO2max in Overweight Hispanic Children},

author = {N C Crespo and G D Ball and G Q Shaibi and M L Cruz and M J Weigensberg and M I Goran},

year  = {2006},

date = {2006-03-01},

journal = {Pediatr Exerc Sci},

volume = {18},

number = {1},

pages = {89--100},

abstract = {Acculturation has been implicated to be associated with physical activity (PA) behaviors in adults; little is known, however, with respect to the pediatric population. The purpose of this study was to determine whether cardiorespiratory fitness (VO2max) and/or PA were associated with acculturation status in overweight Hispanic children. In a sample of 144 children 8-13 years old, acculturation status was determined by place of birth: foreign born (n = 17), 1st generation (n = 101), or 2nd/3rd generation (n = 26), and by questionnaire: less assimilated (n = 76) or more assimilated (n = 34). VO2max was measured using a treadmill protocol, PA was assessed by questionnaire, and body composition by DEXA. ANOVA and ANCOVA were used to determine unadjusted and adjusted group differences, respectively. After adjusting for covariates, the 2nd/3rd generation group had significantly higher VO2max compared with the 1st generation group: 2.26 ± 0.20 L/min vs. 2.15 ± 0.19 L/min},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid17907327,

title = {Predicting abdominal adipose tissue in overweight Latino youth},

author = {G D Ball and T T Huang and M L Cruz and G Q Shaibi and M J Weigensberg and M I Goran},

year  = {2006},

date = {2006-01-01},

journal = {Int J Pediatr Obes},

volume = {1},

number = {4},

pages = {210--216},

abstract = {1) Examine associations between visceral adipose tissue (VAT), subcutaneous abdominal adipose tissue (SAAT), and anthropometric and demographic variables; 2) generate and cross-validate prediction equations for estimating VAT and SAAT in overweight Latino children. Cross-sectional. 196 overweight 8-13-year-old Latino youth. Two-thirds (n = 131) were randomly assigned to a development group to generate prediction equations for VAT and SAAT; one-third (n = 65) was used as a cross-validation group. Anthropometric measurements (height, weight, skinfold thicknesses, and circumferences) were performed. VAT and SAAT were measured using magnetic resonance imaging (MRI). The strongest univariate correlate for VAT was waist circumference (WC) (r = 0.65, p < 0.01) while the strongest correlate for SAAT was hip circumference (r = 0.88, p < 0.001). Regression analyses showed approximately 50% of the variance in VAT was explained by WC (43.8%), Tanner stage (4.2%) and calf skinfold (1.7%). Variance in the SAAT model was explained by WC (77.8%), triceps skinfold (4.2%) and gender (2.3%). Residual analyses showed no bias in either equation. Though mean differences between measured and predicted VAT and SAAT were small, there was a large degree of variability at the individual level especially for VAT. Both VAT and SAAT prediction equations performed well at the group level, but the relatively high degree of variability suggests limited clinical utility of the VAT equation. MRI is currently required to derive an accurate measure of VAT at the individual level.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid17899631,

title = {Deterioration of insulin sensitivity and beta-cell function in overweight Hispanic children during pubertal transition: a longitudinal assessment},

author = {M I Goran and G Q Shaibi and M J Weigensberg and J N Davis and M L Cruz},

year  = {2006},

date = {2006-01-01},

journal = {Int J Pediatr Obes},

volume = {1},

number = {3},

pages = {139--145},

abstract = {To examine 1-year changes in insulin dynamics in overweight Hispanic children at high-risk of type 2 diabetes as a function of body composition and pubertal transition. Longitudinal changes in insulin dynamics, body composition and maturation were determined in 132 Hispanic children (70 boys/62 girls; aged 10.9 +/- 1.8 years). Body composition was determined by dual energy x-ray absorptiometry and Tanner stage by physical examination. Insulin sensitivity (SI), the acute insulin response to glucose (AIR) and the disposition index (DI; an index of beta-cell function) were determined using an insulin modified intravenous glucose tolerance test. These measures were conducted at baseline and 1-year later. Fat mass increased by 13% (3.0 kg) and SI declined by 24%. In repeated measures analysis of variance, the fall in insulin sensitivity over 1 year remained highly significant even after adjusting for baseline fat mass, age, gender and change in fat mass. The fall in SI was not significantly influenced by Tanner stage. However, subjects in earlier maturation showed a compensatory increase in AIR (i.e. appropriate beta-cell compensation), whereas subjects in the latter stages of maturation did not (i.e. poor compensation). These results indicate that failure to increase AIR in response to the fall in SI may be one factor in the pathogenesis of the progression of pediatric type 2 diabetes in this at risk population.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid16599359,

title = {Aerobic fitness among Caucasian, African-American, and Latino youth},

author = {G Q Shaibi and G D Ball and M I Goran},

year  = {2006},

date = {2006-01-01},

journal = {Ethn Dis},

volume = {16},

number = {1},

pages = {120--125},

abstract = {The prevalence of obesity and related comorbidities has dramatically increased in the pediatric population in recent years, and youth from ethnic minorities appear to be disproportionately affected. Although several factors play a role in these ethnic health disparities, evidence suggests fitness may also be an important mediator of disease risk in children. Therefore, the purpose of the present investigation was to compare aerobic fitness (VO2peak) in healthy Caucasian (C), African-American (AA), and Latino (L) youth and to evaluate differences after controlling for gender, maturational stage, and body composition. Seventy-three healthy boys and girls [C (n=18), AA (n=19), and L (n=36)] aged 7-14 years participated in the study. VO2peak was evaluated using an all-out, progressive treadmill protocol, total body composition was estimated via dual-energy x-ray absorptiometry, and ethnicity was determined via parental questionnaire. VO2peak relative to total body mass (mL/kg/min) was significantly lower in Latinos compared to either Caucasian or African-American children. Further, after controlling for gender, maturational stage, and body composition, L (1.68 +/- 0.05 L/min) and AA (1.57 +/- 0.05 L/min) youth had significantly lower VO2peak compared to C (1.84 +/- 0.04 L/ min; P<.05) children. These results suggest that Latino and African-American children have lower aerobic fitness levels than Caucasian children and this effect is independent of gender, maturation, and body composition.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid16423592,

title = {Longitudinal changes in insulin sensitivity, insulin secretion, and beta-cell function during puberty},

author = {G D Ball and T T Huang and B A Gower and M L Cruz and G Q Shaibi and M J Weigensberg and M I Goran},

year  = {2006},

date = {2006-01-01},

journal = {J. Pediatr.},

volume = {148},

number = {1},

pages = {16--22},

abstract = {To determine longitudinal changes in insulin sensitivity (SI), insulin secretion, and beta-cell function during puberty in white and black youth. The tolbutamide-modified frequently sampled intravenous glucose tolerance test and minimal modeling were used to measure SI, the acute insulin response to glucose (AIRg), and beta-cell function (disposition index, DI) in white (n = 46) and black (n = 46) children (mean [+/-SD] age at baseline = 10.2 +/- 1.7 years). Growth curve models (including 272 observations) with SI, AIRg, and DI regressed on Tanner stage were run after adjusting for covariates. After adjusting for covariates, growth curve models revealed that SI decreased and subsequently recovered by the end of puberty in whites and blacks (both p < .05), AIRg decreased linearly across Tanner stages in both races (both p < .001), and DI decreased across puberty in blacks (p = .001) but not in whites (p = .2). White and black youth exhibited transient insulin resistance and diminished AIRg during puberty. The progressive decline in DI among blacks versus whites may reflect a unique effect of puberty on beta-cell compensation in blacks. Future studies are needed to identify whether this difference contributes to the increased risk of type II diabetes in young blacks.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid16344846,

title = {Cardiovascular fitness and physical activity in children with and without impaired glucose tolerance},

author = {G Q Shaibi and G D Ball and M L Cruz and M J Weigensberg and G J Salem and M I Goran},

year  = {2006},

date = {2006-01-01},

journal = {Int J Obes (Lond)},

volume = {30},

number = {1},

pages = {45--49},

abstract = {To examine differences in cardiovascular fitness (VO(2max)) and physical activity levels in overweight Hispanic children with normal glucose tolerance (NGT) vs impaired glucose tolerance (IGT). A total of 173 overweight (BMI percentile 97.0 +/- 3.1) Hispanic children ages 8-13 years with a family history of type 2 diabetes. VO(2max) was measured via a maximal effort treadmill test and open circuit spirometry. Physical activity was determined by questionnaire. Glucose tolerance was established by a 2-h oral glucose challenge (1.75 g of glucose/kg body weight). IGT was defined from an oral glucose tolerance test as a 2-h plasma glucose level > or =140 and <200 mg/dl. IGT was detected in 46 of the 173 participants (approximately 27%); no cases of type 2 diabetes were identified. No significant differences were found between youth with NGT and those with IGT in absolute VO(2max) (2.2 +/- 0.6 vs 2.1 +/- 0.5 l/min), VO(2max) adjusted for gender, age, and body composition (2.2 +/- 0.2 vs 2.1 +/- 0.2 l/min), or recreational physical activity levels (8.7 +/- 8.2 vs 6.9 +/- 6.2 h/week). Overweight Hispanic youth with IGT exhibit similar levels of VO(2max) and physical activity compared to their NGT counterparts. Longitudinal analyses are necessary to determine whether fitness/activity measures contribute significantly to diabetes risk over time in this group.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid16344845,

title = {Crossvalidation of anthropometry against magnetic resonance imaging for the assessment of visceral and subcutaneous adipose tissue in children},

author = {P Brambilla and G Bedogni and L A Moreno and M I Goran and B Gutin and K R Fox and D M Peters and P Barbeau and M De Simone and A Pietrobelli},

year  = {2006},

date = {2006-01-01},

journal = {Int J Obes (Lond)},

volume = {30},

number = {1},

pages = {23--30},

abstract = {The study of the relationship between anthropometry and visceral adipose tissue (VAT) is of great interest because VAT is associated with many risk factors for noncommunicable diseases and anthropometry is easy to perform in clinical practice. The studies hitherto available for children have, however, been performed on small sample sizes. Pooling of the data of studies published from 1992 to 2004 as indexed on Medline. To assess the relationship between anthropometry and VAT and subcutaneous adipose tissue (SAT) as measured by magnetic resonance imaging (MRI) in children and to analyze the effect of age, gender, pubertal status and ethnicity. Eligible subjects were 7-16 year-old, with availability of VAT and SAT, gender, ethnicity, body mass index (BMI) and waist circumference (WC). A total of 497 subjects were collected from seven different investigators and 407 of them (178 Caucasians and 229 Hispanics) were analyzed. Despite ethnic differences in MRI data, BMI, WC and age, no difference in VAT was found between Caucasians and Hispanics after correction for SAT and BMI. Univariate regression analysis identified WC as the best single predictor of VAT (64.8% of variance) and BMI of SAT (88.9% of variance). The contribution of ethnicity and gender to the unexplained variance of the VAT-WC relationship was low (< or =3%) but significant (P < or =0.002). The different laboratories explained a low (< or =4.8%) but significant (P < 0.0001) portion of the unexplained variance of the VAT-WC and SAT-BMI relationships. Prediction equations for VAT (VAT (cm(2)) = 1.1 x WC (cm)-52.9) and SAT (SAT (cm(2)) = 23.2 x BMI (kg/m(2))-329) were developed on a randomly chosen half of the population and crossvalidated in the remaining half. The pure error of the estimate was 13 cm(2) for VAT and 57 cm(2) for SAT. WC can be considered a good predictor of VAT as well as BMI of SAT. The importance of ethnicity and gender on VAT estimation is not negligible.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid17062815,

title = {Associations of adiposity with measured and self-reported academic performance in early adolescence},

author = {T T Huang and M I Goran and D Spruijt-Metz},

year  = {2006},

date = {2006-00-01},

journal = {Obesity (Silver Spring)},

volume = {14},

number = {10},

pages = {1839--1845},

abstract = {To examine the associations of adiposity with measured and self-reported academic performance independently of demographics and physical activity among U.S. adolescents. We surveyed 666 students 11 to 14 years old from seven middle schools in Los Angeles, CA. Weight and height were measured. Actual grade point average was obtained from school records. Self-reported school grades and physical activity time were measured by questionnaire. Adiposity measures included BMI, BMI percentile (> or =85th percentile defined as at-risk-of-overweight), and percentage body fat (bioimpedance). After adjusting for gender, ethnicity, age, and physical activity time, overweight at-risk status, BMI, and percentage body fat were negatively related to only self-reported (p < 0.01) but not measured grades. Level of moderate-to-vigorous physical activity time was negatively related to measured and self-reported grades, independently of adiposity (p < 0.01). To our knowledge, this is the first study to examine both body mass and body fat in relation to measured and self-reported school grades. Adiposity did not relate to actual academic performance in a sample of predominantly Latino and Asian-American adolescents. The use of measured vs. self-reported academic outcomes may represent different constructs and influence study conclusions. Cultural factors may also play a role in our findings, but this requires further study.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid16077712,

title = {Insulin sensitivity, insulin secretion and beta-cell function during puberty in overweight Hispanic children with a family history of type 2 diabetes},

author = {G D Ball and M J Weigensberg and M L Cruz and G Q Shaibi and H A Kobaissi and M I Goran},

year  = {2005},

date = {2005-12-01},

journal = {Int J Obes (Lond)},

volume = {29},

number = {12},

pages = {1471--1477},

abstract = {To examine cross-sectional differences in insulin sensitivity, insulin secretion and beta-cell function during puberty in overweight Hispanic boys and girls with a family history of type 2 diabetes. This cross-sectional, observational study included 214 8-13-y-old Hispanic children with a BMI percentile > or = 85th percentile and family history of type 2 diabetes. Participants underwent a physical examination, body composition measures, oral glucose tolerance test (OGTT), and frequently-sampled intravenous glucose tolerance test. Unadjusted and adjusted general linear models (GLM) tested whether insulin/glucose dynamics differed by Tanner stage and gender. Unadjusted group comparisons showed that fasting insulin increased whereas insulin sensitivity (SI) and the disposition index (DI) (a measure of pancreatic beta-cell function) decreased across Tanner stage groups (all P < 0.05). No differences in the acute insulin response to glucose (AIRg), fasting glucose or 2-h glucose were found. After adjusting for covariates, there was no independent effect of Tanner stage on SI (P = 0.9) or AIRg (P = 0.2), but DI was slightly lower in later Tanner stages suggesting decreased beta-cell function in the more mature groups (P = 0.10). Overweight Hispanic children with a family history of type 2 diabetes may represent a unique population given that pubertal insulin resistance was not evident once analyses controlled for body composition. Longitudinal analyses are required to determine whether the slightly diminished beta-cell function in later Tanner stages plays a role in the development of type 2 diabetes.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid16280431,

title = {The relation of sugar intake to beta cell function in overweight Latino children},

author = {J N Davis and E E Ventura and M J Weigensberg and G D Ball and M L Cruz and G Q Shaibi and M I Goran},

year  = {2005},

date = {2005-11-01},

journal = {Am. J. Clin. Nutr.},

volume = {82},

number = {5},

pages = {1004--1010},

abstract = {Few studies have investigated the association between sugar intake and insulin dynamics in children, and none have examined this association in overweight Latino youth. We aimed to examine the relation between dietary components, especially sugar intake, and insulin dynamics in overweight Latino youth. We examined 63 overweight Latino children aged 9-13 y. Dietary intake was determined by 3-d records, and body composition was measured with dual-energy X-ray absorptiometry. Insulin sensitivity (S(I)), acute insulin response (AIR), and disposition index (an index of beta cell function) were measured by using a frequently sampled intravenous-glucose-tolerance test and minimal modeling. Hierarchical regression analysis ascertained the potential independent relation between insulin dynamics and dietary components. The relation between macronutrient intake and any variable related to insulin dynamics was not significant. However, higher total sugar intake, although not related to S(I), was significantly associated with lower AIR (beta = -0.296},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid16183814,

title = {Early ethnic difference in insulin-like growth factor-1 is associated with African genetic admixture},

author = {P B Higgins and J R Fernandez and M I Goran and B A Gower},

year  = {2005},

date = {2005-11-01},

journal = {Pediatr. Res.},

volume = {58},

number = {5},

pages = {850--854},

abstract = {IGF-1 is a growth-promoting hormone. Numerous studies have reported higher systemic concentrations of IGF-1 among African Americans (AA) compared with European Americans (EA) before puberty. We conducted this cross-sectional analysis to determine whether African ancestral genetic background, dietary factors, energy expenditure, adiposity, and socioeconomic status contribute to this difference. Children were prepubertal, AA and EA males and females. Genetic admixture was assessed from approximately 20 ancestry informative genetic markers. Body composition was determined by dual-energy x-ray absorptiometry; intake of energy, carbohydrate, protein, and fat by 24-h dietary recall; activity-related energy expenditure by doubly labeled water and indirect calorimetry; and socioeconomic status (SES) according to the Hollingshead scale. IGF-1 and IGF binding protein-3 (IGFBP-3) were measured using immunoradiometric assays. AA children had significantly greater IGF-1 compared with EA children (p < 0.01). In addition, AA children had lower SES and greater protein intake relative to EAs (p < 0.05 for both). Multiple linear regression analysis revealed that the only significant independent predictors of IGF-1 were IGFBP-3 and African admixture (p < 0.01 for both). Thus, our data suggest that the greater IGF-1 of AA relative to EA children could have a genetic basis.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid16222067,

title = {Dietary fat intake and insulin resistance in black and white children},

author = {M J Weigensberg and G D Ball and G Q Shaibi and M L Cruz and B A Gower and M I Goran},

year  = {2005},

date = {2005-09-01},

journal = {Obes Res.},

volume = {13},

number = {9},

pages = {1630--1637},

abstract = {The purpose of this study was to determine whether dietary fat intake above current Acceptable Macronutrient Distribution Range (AMDR) guidelines was associated with greater insulin resistance in black and white children. We studied 142 healthy children (n = 81 whites},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid16123368,

title = {Adiponectin is lower among African Americans and is independently related to insulin sensitivity in children and adolescents},

author = {N C Bush and B E Darnell and R A Oster and M I Goran and B A Gower},

year  = {2005},

date = {2005-09-01},

journal = {Diabetes},

volume = {54},

number = {9},

pages = {2772--2778},

abstract = {Adiponectin is inversely related to adiposity and positively correlated with insulin sensitivity (S(i)). Sparse data exist on the contributions of ethnicity and body fat distribution to variance in serum adiponectin. Hypotheses tested were that adiponectin would be lower in African Americans compared with Caucasians; that adiponectin would be inversely related to central, not peripheral, fat; that adiponectin would be positively associated with S(i); and that baseline adiponectin would predict change in S(i) over 2 years in 150 African-American and Caucasian youth. Multiple linear regression modeling showed that adiponectin was lower in African-American versus Caucasian children (adjusted means 10.8 +/- 0.5 vs. 12.3 +/- 0.5 microg/ml, respectively; P < 0.05); inversely related to trunk fat (P < 0.05); and positively related to limb fat (P < 0.01). Addition of the acute insulin response to glucose to the model eliminated the significance of ethnicity. S(i), which was positively related to adiponectin (P < 0.05), was lower in African Americans (P < 0.001) and girls (P < 0.05). Baseline adiponectin did not predict change in S(i) over 2 years. In conclusion, adiponectin was positively correlated with S(i), inversely related to central fat, and positively related to peripheral fat. In addition, higher acute insulin response to glucose explained lower adiponectin among African-American children.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid15947715,

title = {Cardiovascular fitness and the metabolic syndrome in overweight latino youths},

author = {G Q Shaibi and M L Cruz and G D Ball and M J Weigensberg and H A Kobaissi and G J Salem and M I Goran},

year  = {2005},

date = {2005-06-01},

journal = {Med Sci Sports Exerc},

volume = {37},

number = {6},

pages = {922--928},

abstract = {To determine whether cardiovascular fitness (.)VO(2max) is associated with the metabolic syndrome and its individual features in overweight Latino youths. A total of 163 overweight Latino boys and girls (body mass index (BMI) percentile = 97.0 +/- 3.1; age = 11.2 +/- 1.7 yr) with a family history of Type 2 diabetes participated in this investigation. The metabolic syndrome was defined as having three or more of the following risk factors: abdominal obesity, high blood pressure, low HDL-cholesterol, high triglycerides, and impaired glucose tolerance. (.)VO(2max) was determined by a progressive treadmill test to exhaustion, and body composition was assessed using dual energy x-ray absorptiometry. (.)VO(2max) was not correlated with any individual risk factor of the metabolic syndrome after adjusting for gender, age, and body composition in partial analysis. Furthermore, ANCOVA revealed that children with zero, one, two, or three or more risk factors did not differ in regards to fitness levels. (.)VO(2max) is not independently associated with the metabolic syndrome or any individual feature in overweight youths of Latino ethnicity after controlling for differences in confounding variables.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid15677795,

title = {Impaired glucose tolerance and bone mineral content in overweight latino children with a family history of type 2 diabetes},

year  = {2005},

date = {2005-02-01},

journal = {Diabetes Care},

volume = {28},

number = {2},

pages = {372--378},

abstract = {Research on the skeletal status of pre-diabetic (type 2 diabetic) children is warranted. We examined the hypothesis that bone mineral content (BMC) and bone mineral density (BMD) will be lower in children with impaired glucose tolerance (IGT) versus normal glucose tolerance (NGT). Total body BMC and BMD of 184 overweight Latino children (106 boys, 78 girls, 11.9 +/- 1.7 years) with a family history of type 2 diabetes were measured using dual-energy X-ray absorptiometry. Glucose tolerance was assessed by 2-h glucose after an oral glucose tolerance test. Area under the insulin curve (AUC) assessed the cumulative insulin response to oral glucose. Acute insulin response to glucose (AIR) was determined by an intravenous glucose tolerance test. Partial correlations revealed an inverse relationship between BMC and AIR (r = -0.29},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid16011474,

title = {Pediatric obesity and insulin resistance: chronic disease risk and implications for treatment and prevention beyond body weight modification},

author = {M L Cruz and G Q Shaibi and M J Weigensberg and D Spruijt-Metz and G D Ball and M I Goran},

year  = {2005},

date = {2005-01-01},

journal = {Annu Rev Nutr.},

volume = {25},

pages = {435--468},

abstract = {The study of childhood obesity has continued to grow exponentially in the past decade. This has been driven in part by the increasing prevalence of this problem and the widespread potential effects of increased obesity in childhood on lifelong chronic disease risk. The focus of this review is on recent findings regarding the link between obesity and disease risk during childhood and adolescence. We describe recent reports relating to type 2 diabetes in youth (2), prediabetes (69, 166), metabolic syndrome (33, 35), polycystic ovarian syndrome (77), and nonalcoholic fatty liver disease (58, 146), and the mediating role of insulin resistance in these conditions. In addition, we review the implications of this research for the design of more effective treatment and prevention strategies that focus more on the improvement of obesity-related metabolic abnormalities and chronic disease risk reduction than on the conventional energy balance approach that focuses on weight management.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid16277827,

title = {Estimating energy requirements: regression based prediction equations or multiples of resting metabolic rate},

author = {M I Goran},

year  = {2005},

date = {2005-00-01},

journal = {Public Health Nutr},

volume = {8},

number = {7A},

pages = {1184--1186},

abstract = {Energy requirements have traditionally been determined based on multiples of resting metabolic rate (RMR), known as Physical Activity Levels (PAL). With more data from doubly labelled water studies alternative approaches for estimating energy requirements have been suggested. Statistical analysis reveals that body weight explains more of the variance in total energy expenditure (TEE) than does RMR. The explanation for this phenomenon is that body weight contributes to the variance of both RMR and the other major determinant of TEE, i.e. physical activity related energy expenditure. Thus, in effect, the regression-based approach provides a more physiological appropriate model for TEE. Its major departure from tradition, difference from current adult proposals, and time taken for acceptance are the disadvantages of the regression-based approach.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid16186290,

title = {Decreased beta-cell function in overweight Latino children with impaired fasting glucose},

author = {M J Weigensberg and G D Ball and G Q Shaibi and M L Cruz and M I Goran},

year  = {2005},

date = {2005-00-01},

journal = {Diabetes Care},

volume = {28},

number = {10},

pages = {2519--2524},

abstract = {To determine whether overweight Latino children with impaired fasting glucose (IFG) (> or = 100 mg/dl) have increased insulin resistance or decreased beta-cell function compared with those with normal fasting glucose (NFG). We studied 207 healthy overweight Latino children, aged 8-13 years, with a family history of type 2 diabetes. Fasting and 2-h glucose and insulin were assessed by oral glucose tolerance test. Insulin sensitivity (S(i)), the acute insulin response to glucose (AIRg), and the disposition index (DI; an index of beta-cell function) were determined using the insulin-modified intravenous glucose tolerance test and minimal modeling. Body composition was determined by dual-energy X-ray absorptiometry. There were no differences in body composition between NFG (n = 182) and IFG (n = 25) children. Compared with children with NFG, children with IFG had higher fasting and 2-h glucose values and higher fasting insulin. After adjusting for covariates, children with IFG had no difference in S(i) but 15% lower DI than NFG children (2,224 +/- 210 vs. 2,613 +/- 76, P < 0.05). Multivariate linear regression showed that AIRg and DI, but not S(i), were significant predictors of fasting blood glucose. In overweight Latino adolescents with a family history of type 2 diabetes, IFG is associated with impaired beta-cell function and therefore may identify children likely to be at risk for progression to type 2 diabetes. The actual risk of progression of IFG to type 2 diabetes remains to be determined by prospective longitudinal studies.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid15897486,

title = {Interactive multimedia for promoting physical activity (IMPACŦ) in children},

author = {M I Goran and K Reynolds},

year  = {2005},

date = {2005-00-01},

journal = {Obes. Res.},

volume = {13},

number = {4},

pages = {762--771},

abstract = {To develop and examine the efficacy of a computer-based interactive multimedia curriculum for promoting physical activity in fourth grade children. The participants were 209 fourth grade children (mean age of 9.5 +/- 0.4 years) from four schools. Two schools received an 8-week multimedia intervention delivered by interactive CD-ROM, supplemented by four classroom and four homework assignments. Two control schools received educational CD-ROMS not related to health outcomes. Measures conducted before and after intervention included height, weight, percentage body fat (bioimpedance analysis), physical activity (5-day accelerometry), and psychosocial aspects of physical activity by questionnaire. All outcomes were examined using general linear models. There was a significant treatment effect for obesity reduction in girls but not in boys. There were no significant treatment effects on total physical activity by accelerometry (total counts per minute), but there was an overall treatment effect on reducing percent of time in moderate-intensity activity (16.5% to 15% of the time) and significant sex-by- treatment interactions for light-intensity activities (reduction in boys from 78% to 75% of the time and an increase in girls from 78% to 81% of the time). There were marginal/significant treatment effects for improvements in behavioral outcomes, including self-efficacy (p = 0.06), social norms (p = 0.07), and outcome expectancies (p = 0.049). The interactive multimedia curriculum favored an improvement in obesity indices in girls and was associated with subtle changes in physical activity in girls and general improvement in psychosocial outcomes related to physical activity.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid15161797,

title = {Relation between acanthosis nigricans and insulin sensitivity in overweight Hispanic children at risk for type 2 diabetes},

author = {H A Kobaissi and M J Weigensberg and G D Ball and M L Cruz and G Q Shaibi and M I Goran},

year  = {2004},

date = {2004-06-01},

journal = {Diabetes Care},

volume = {27},

number = {6},

pages = {1412--1416},

abstract = {To investigate in a population of Hispanic children if 1) the presence of acanthosis nigricans (AN) is related to insulin sensitivity (S(i)) independent of adiposity and 2) scale scoring AN severity adds to the clinical estimation of insulin sensitivity, above and beyond the presence or absence AN alone. The study population, 131 Hispanic overweight children (mean BMI percentile 97.0 +/- 3.1, 72 boys, 59 girls, ages 8-13 years, mean Tanner stage 2.4 +/- 1.5) with a family history of type 2 diabetes, underwent a physical examination of the neck to determine AN absence or presence (0-1), AN extent score (0-4 scale), AN texture score (0-3 scale), and an AN combined score (extent + texture; 0-7 scale). S(i) was measured by the frequently sampled intravenous glucose tolerance test and minimal modeling. Multivariate linear regression analysis was used to determine the role of BMI and AN in predicting S(i). BMI was the main predictor of S(i), explaining approximately 41% of the variance. The presence of AN explained an additional 4% of the variability in S(i); scale scoring of AN extent or texture did not significantly improve the prediction. Although AN is an independent risk factor for insulin resistance in overweight Hispanic children at risk for type 2 diabetes, body adiposity is the primary determinant of insulin sensitivity. In addition, scale scoring AN seems of minimal usefulness in clinically estimating the severity of insulin resistance over and above assessing the presence or absence of AN and calculating BMI.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid14764281,

title = {The metabolic syndrome in children and adolescents},

author = {M L Cruz and M I Goran},

year  = {2004},

date = {2004-02-01},

journal = {Curr. Diab. Rep.},

volume = {4},

number = {1},

pages = {53--62},

abstract = {The metabolic syndrome was recently defined by the Adult Treatment Panel III. Despite a lack of uniform definition of the syndrome in pediatrics, recent studies have shown that the syndrome develops during childhood and is highly prevalent among overweight children and adolescents. The hypothesized central role of insulin resistance and obesity as a common underlying feature of the metabolic syndrome also appears to be already manifested in childhood. In view of the current obesity epidemic in children and adolescents, there is a vital need to provide adequate guidelines for the definition of the metabolic syndrome in pediatrics and for the development of screening and treatment strategies. This article focuses on the above issues, as well as on the impact of the syndrome on two major disease outcomes, type 2 diabetes and cardiovascular disease.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid15002929,

title = {Overweight as a risk factor in children: a focus on ethnicity},

author = {S D Nesbitt and M O Ashaye and N Stettler and J M Sorof and M I Goran and R Parekh and B E Falkner},

year  = {2004},

date = {2004-01-01},

journal = {Ethn Dis},

volume = {14},

number = {1},

pages = {94--110},

abstract = {The prevalence of overweight in youth is increasing dramatically in the United States. The intimate relationship of obesity and overweight with cardiovascular risk factors and diabetes in adults raises concern for the likelihood of subsequent disease development in children. Ethnic minorities are so disproportionately affected by overweight that a call to action is necessary. The International Society on Hypertension in Blacks convened this work group as part of a larger effort to focus on cardiovascular risk protection beginning in childhood and adolescence, entitled the "Children are Our Messengers: Changing the Health Message" initiative. This summary article reviews the data on cardiovascular risk factors and overweight in ethnic children and adolescents, and culminates in a practical algorithm for evaluating overweight children for cardiovascular risk.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid14742845,

title = {Insulin sensitivity, cardiorespiratory fitness, and physical activity in overweight Hispanic youth},

author = {G D Ball and G Q Shaibi and M L Cruz and M P Watkins and M J Weigensberg and M I Goran},

year  = {2004},

date = {2004-01-01},

journal = {Obes. Res.},

volume = {12},

number = {1},

pages = {77--85},

abstract = {To determine whether cardiorespiratory fitness and/or physical activity (PA) were related to measures of insulin sensitivity and secretion independent of body composition in overweight Hispanic children. Ninety-five Hispanic children (n = 55 boys; n = 40 girls; 8 to 13 years old) participated in this investigation. The frequently sampled intravenous glucose tolerance test was used to determine the insulin sensitivity index (SI), the acute insulin response, and the disposition index. Cardiorespiratory fitness [maximal oxygen uptake (VO(2max))] was evaluated using a treadmill protocol, and PA was determined by an interviewer-administered questionnaire. Body composition was measured using DXA. Unadjusted correlations indicated that VO(2max) (milliliters of O(2) per minute) was negatively related to SI (r = -0.46, p < 0.05) and disposition index (r = -0.31, p < 0.05) and positively associated with fasting insulin (r = 0.29, p < 0.05), but these relationships were no longer significant once gender, Tanner stage, fat mass, and soft lean tissue mass were included as covariates (all p > 0.05). Multivariate linear regression analysis showed that body fat mass explained 53% of the variance in SI and that VO(2max) (milliliters of O(2) per minute) was not independently related to SI. Cardiorespiratory fitness was positively related to both fat mass (r = 0.43, p < 0.001) and soft lean tissue mass (r = 0.89, p < 0.001). PA was not related to any measure of insulin sensitivity and secretion. Cardiorespiratory fitness, as determined by VO(2max) (milliliters of O(2) per minute), was not independently related to insulin sensitivity or secretion, suggesting that VO(2max) influences insulin dynamics indirectly through fat mass.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid14715851,

title = {Impaired glucose tolerance and reduced beta-cell function in overweight Latino children with a positive family history for type 2 diabetes},

author = {M I Goran and R N Bergman and Q Avila and M Watkins and G D Ball and G Q Shaibi and M J Weigensberg and M L Cruz},

year  = {2004},

date = {2004-01-01},

journal = {J. Clin. Endocrinol. Metab.},

volume = {89},

number = {1},

pages = {207--212},

abstract = {The objective of this study was to examine relationships between impaired glucose tolerance (IGT) and body composition and insulin-related phenotypes in 150 overweight Latino children with a family history of type 2 diabetes. Glucose tolerance was assessed by an oral glucose challenge. Body composition was assessed by dual energy x-ray absorptiometry and magnetic resonance imaging. Insulin sensitivity, the acute insulin response, and the disposition index (DI), as an index of beta-cell function, were determined by an iv glucose tolerance test and compared between normal glucose-tolerant and IGT children. IGT was present in 28% of children, and was similar across obesity groups, but higher in children exposed to gestational diabetes mellitus (41% IGT). There were no significant differences in body composition, fat distribution, insulin sensitivity, or acute insulin response, but DI was significantly lower in IGT children by 16% (P < 0.02), and DI was inversely related to age. In conclusion, IGT is present in 28% of overweight Latino children with a family history of type 2 diabetes, is not influenced by obesity, is more prevalent in children exposed to gestational diabetes mellitus, and is related to poor beta-cell function, which shows signs of deterioration with age in this population.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid14715836,

title = {The metabolic syndrome in overweight Hispanic youth and the role of insulin sensitivity},

author = {M L Cruz and M J Weigensberg and T T Huang and G Ball and G Q Shaibi and M I Goran},

year  = {2004},

date = {2004-01-01},

journal = {J. Clin. Endocrinol. Metab.},

volume = {89},

number = {1},

pages = {108--113},

abstract = {The prevalence of the metabolic syndrome is highest among Hispanic adults. However, studies exploring the metabolic syndrome in overweight Hispanic youth are lacking. Subjects were 126 overweight children (8-13 yr of age) with a family history for type 2 diabetes. The metabolic syndrome was defined as having at least three of the following: abdominal obesity, low high-density lipoprotein (HDL) cholesterol, hypertriglyceridemia, hypertension, and/or impaired glucose tolerance. Insulin sensitivity was determined by the frequently sampled iv glucose tolerance test and minimal modeling. The prevalence of abdominal obesity, low HDL cholesterol, hypertriglyceridemia, systolic and diastolic hypertension, and impaired glucose tolerance was 62, 67, 26, 22, 4, and 27%, respectively. The presence of zero, one, two, or three or more features of the metabolic syndrome was 9, 22, 38, and 30%, respectively. After controlling for body composition, insulin sensitivity was positively related to HDL cholesterol (P < 0.01) and negatively related to triglycerides (P < 0.001) and systolic (P < 0.01) and diastolic blood pressure (P < 0.05). Insulin sensitivity significantly decreased (P < 0.001) as the number of features of the metabolic syndrome increased. In conclusion, overweight Hispanic youth with a family history for type 2 diabetes are at increased risk for cardiovascular disease and type 2 diabetes, and this appears to be due to decreased insulin sensitivity. Improving insulin resistance may be crucial for the prevention of chronic disease in this at-risk population.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid12832319,

title = {Association between insulin sensitivity and post-glucose challenge plasma insulin values in overweight Latino youth},

author = {M J Weigensberg and M L Cruz and M I Goran},

year  = {2003},

date = {2003-07-01},

journal = {Diabetes Care},

volume = {26},

number = {7},

pages = {2094--2099},

abstract = {To determine associations between directly measured insulin sensitivity (SI) and oral glucose tolerance test (OGTT)-derived plasma insulin values, or calculated SI indices, in overweight peripubertal Latino children at risk for type 2 diabetes. Thirty overweight Latino children with a family history of type 2 diabetes, aged 8-13 years, Tanner stages 1-2, underwent an OGTT. Fasting and 2-h plasma insulin values and OGTT-derived SI indices were compared with SI derived from a frequently sampled intravenous glucose tolerance test (FSIGTT) with minimal model analysis, before and after adjustment for total body fat and lean tissue mass, or BMI. FSIGTT-derived SI for all subjects was 1.62 +/- 0.78 x 10(-4) min (-1) x (microU/ml), with no sex differences. SI correlated (all P values < 0.001) with fasting (r = -0.57) and 2-h (r = -0.58) plasma insulin and all SI indices (r = -0.57 to 0.67). After adjusting for total body fat and lean tissue mass, or BMI, the associations between SI and either fasting insulin or fasting SI indices were no longer significant. However, the 2-h insulin and post-glucose challenge SI indices maintained significant independent associations with SI, even after adjustment for body composition. In overweight, peripubertal Latino children at risk for type 2 diabetes, the 2-h plasma insulin value and postchallenge SI indices are better independent correlates of SI than fasting values, after accounting for body composition. The 2-h insulin may therefore be superior to fasting insulin as a single blood sample value for clinical or epidemiological estimates of SI, especially when combined with assessment of body composition.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid14655523,

title = {Prevention of type 2 diabetes in young people: a theoretical perspective},

author = {T T Huang and M I Goran},

year  = {2003},

date = {2003-03-01},

journal = {Pediatr Diabetes},

volume = {4},

number = {1},

pages = {38--56},

abstract = {Type 2 diabetes in youth is an increasing public health concern, especially in certain minority populations. The current paper consists of four sections. First, we establish the significance of the problem by presenting an overview of epidemiological and physiological evidence. Second, we discuss behavioral issues relevant to the prevention of type 2 diabetes in youth. Third, a qualitative review of existing prevention interventions specific to type 2 diabetes in youth is presented. Results suggest that modest improvements in social cognitive, dietary, and exercise outcomes are possible with diabetes intervention studies, although beneficial changes are difficult to sustain over the long term. Although theoretical frameworks are not always explicit, most studies have utilized elements of the social cognitive theory. Less attention has been paid to sociocultural and community organization variables. Finally, the paper discusses issues of risk definition and intervention sustainability, and presents a comprehensive, theoretically diverse model for the prevention of type 2 diabetes in youth. In summary, we suggest that theories of the natural history and pathophysiology of type 2 diabetes are important to identify modifiable risk factors, while theories of behavioral change are essential to modify the risk factors identified. The combination of sound physiological and behavioral theories should form the basis of prevention intervention design. In addition, an ecologic approach that takes into consideration the dynamic interactions of personal, social, and environmental factors would best promote the long-term adoption of healthful behaviors in a supportive, meaningful, and personally enjoyable context.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid12519851,

title = {Influence of family history of type 2 diabetes on insulin sensitivity in prepubertal children},

author = {M I Goran and K Coronges and R N Bergman and M L Cruz and B A Gower},

year  = {2003},

date = {2003-01-01},

journal = {J. Clin. Endocrinol. Metab.},

volume = {88},

number = {1},

pages = {192--195},

abstract = {The objective of this study was to examine the influence of positive family history (FH) of type 2 diabetes (T2D) on aspects of insulin resistance in prepubertal children. Twenty-one children (Tanner stage I or II) with a positive FH were compared with children with no FH. FH was defined by presence of T2D in a parent or grandparent as assessed by interview. The two groups of children were matched for age, gender, Tanner stage, ethnicity, geographical location, and body fat mass using a pair-matched design. These 21 pairs of children included Caucasian, African American, and Hispanic children who were studied either in Birmingham, Alabama, or Los Angeles, California, using similar techniques. Insulin sensitivity (S(I)) and the acute insulin response to glucose (AIR) were determined by an iv glucose tolerance test and minimal modeling, and body composition was determined by dual-energy x-ray absorptiometry. There were no significant differences in fasting glucose or insulin, S(I), AIR, the disposition index (product of S(I) and AIR), or body composition between children with a FH vs. those without a FH of T2D, and there were no significant differences in these parameters when the data were analyzed separately in each ethnic group. In conclusion, a positive FH for T2D does not seem to have any significant effect on insulin sensitivity, as assessed by the minimal model and associated risk factors for T2D in young children.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}