Background: WHO has recommended that adults of South Asian (SA) ethnicity need to have lower body mass index (BMI) cut-off to define overweight and obesity compared to White Caucasians (WC). The background for this is the increasing evidence that obesity-related morbidities are much higher at a lower BMI among SA compared to WC adults.
Objective: The aim of our study was to evaluate differences in measures of insulin sensitivity amongst children and adolescents classed as overweight or obese of either SA or WC ethnicity
Method: Retrospective analysis of medical records of all children and adolescents defined as overweight or obese using BMI and British 1990 growth reference BMI charts were used as the criteria to define each group. Ethnicity data was based on self reporting by the family. Comparison between the two groups included fasting glucose, insulin, homeostasis model assessment (HOMA-IR), 120 minutes glucose levels after oral glucose tolerance test (OGTT) and HbA1c. Statistical analysis was done using PRISM software.
Results: A total of 143 patients who fulfilled criteria were identified. 67 (47%) were SA and 76 (53%) WC. Age and sex distribution between the two groups were identical. SA group had a lower mean BMI (SA 32.1±5.9 vs WC 36.4±7.7; P=0.0003) and lower mean BMI SDS (SA 3.0±0.7 vs WC 3.5±0.7; P<0.0001) compared to WC. HbA1c levels (SA 40±8mmol/mol vs WC 37±5, P=0.02), Fasting insulin (SA 32.8±21.4 miu/l vs WC 25.3±17.0; P=0.03) and HOMA-IR index (SA 7.2±5.1 vs WC 5.3±3.8, P=0.02) was significantly higher in the SA compared to WC. Fasting glucose and 2 hour glucose after OGTT were not statistically significant between the groups. 2 children in WC and 4 in SA were diagnosed with Type 2 Diabetes.
Conclusion: Out study reveals that obese and overweight children and adolescents of SA had significant abnormality of insulin sensitivity markers at a lower BMI compared to WC. This highlights the need to consider lowering the BMI threshold cut-off to define overweight and obesity among SA children and adolescents similar to those recommended in adults.
23 - 25 Nov 2016
British Society for Paediatric Endocrinology and Diabetes