BMI > 95%-For-Age-And-Sex Is Associated with Greater Depression and Insulin Resistance in Native American Youth

Zephier, Ramona; Lasley, Sylvia; Lane, James; Brushbreaker, Connie; Ryschon, Timothy; Erickson, Judi; Sun, Junfeng; Valandra, Ron; Frahm, Christin; Larsen, Jennifer
June 2007
Diabetes;Jun2007 Supplement 1, Vol. 56, pA472
Academic Journal
Diabetes is more common in Native Americans than other ethnic groups. The incidence of diabetes is increasing faster in Native American adolescents than other age groups. Insulin resistance is known to precede diabetes, and lifestyle changes can improve future risk of diabetes in individuals with insulin resistance so identifying risk is important to preventing diabetes. In collaboration with the Diabetes Prevention Program of the Rosebud Sioux Tribe, we are screening Native American youth, ages 5-18 years to 1) determine prevalence of diabetes and impaired glucose tolerance, 2) identify which factors best predict insulin resistance, including environmental factors such as life stresses, and 3) determine if cultural affiliation is associated with lower insulin resistance. HOMA-IR was used to quantify insulin resistance and CES-D was used as a screening tool for depression. We have screened 65 youth, (38M/27F) with mean age 10 ± 0.45 y (SEM). Body mass index (BMI) % for-age-andsex was 79% ± 2 (SEM), with 55% >85%-for-age-and-sex, considered at risk for overweight and 28% >95%- for-age-and-sex, considered overweight, using CDC guidelines. Blood pressure was greater than 90%-for-age-and-sex in 4%; 16% had acanthosis nigricans, 6% had triglycerides > 150 mg/dl; 8% had albuminuria; and 22% had a HOMA-IR >4, used as the cut-off value for insulin resistance in adolescents. None screened to date had diabetes and only 5% had impaired fasting glucose or impaired glucose tolerance. Mean HOMA-IR was elevated, and significantly greater, in those with BMI >95% (6.0+ 1.0) compared to those <95% (2.0+0.2; p<0.0001). CES-D score was also greater in those with BMI% >95%, indicating greater depression (p=0.0008). This preliminary data suggests that in Native American youth, BMI%-for-age-and-sex >95% is associated with significantly greater insulin resistance and depression score. Whether depression is the cause of elevated BMI and insulin resistance or elevated BMI causes depression still needs to be determined.


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