Diabetes
Permanent URI for this collectionhttps://hdl.handle.net/20.500.12503/21757
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Browsing Diabetes by Author "Franks, Susan"
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Item COMPARISON OF BODY MASS INDEX PERCENTILE AND PERCENT BODY FAT ON RISK FACTORS FOR TYPE 2 DIABETES MELLITUS IN CHILDREN AGED 10-14(2014-03) Fernando, Shane I.; Fulda, Kimberly; Franks, Susan; Bowman, W. Paul; Shah, Deep; Proffitt-Leyva, Randi; Bawa, Binky; Habiba, NusrathThe growing rate of type 2 diabetes mellitus (T2DM) in children presents a critical public health problem for the future. However, assessment of T2DM risk among children can be challenging. Therefore, to improve assessment of risk, we examined the association between BMIP (body mass index percentile, a traditional indicator) with risk, compared to the association of percent body fat (PBF) with risk. Methods: Data were obtained from 290 10-14 year old adolescents who were patients in the pediatrics department of the University of North Texas Health Science Center, patients at Seminary Clinic in Fort Worth and recruited from community events. During study visits, subjects’ BMI percentile and percent body fat were obtained using standard height/weight measurements as well as through the use of a Tanita body composition device. Associations were then assessed using statistical regression models. Results: Among 290 subjects, 78.2% were of Hispanic origin, with approximately 13.4% being Black. Approximately 51% of subjects were female, while age distribution was evenly spread across 10-14. Logistic regression models found that both PBF and BMIP were significantly associated with Acanthosis nigricans (PBF: Sβ 0.584 vs. BMIP: Sβ 0.489), average systolic BP above 95th percentile (PBF: Sβ 0.219 vs. BMIP: Sβ 0.124), family history of T2DM (PBF: Sβ 0.189 vs. BMIP: Sβ 0.172), and high blood sugar test (PBF: Sβ 0.152 vs. BMIP: Sβ 0.119). Conclusions: The data from this study provides evidence that PBF may be a better measurement of T2DM risk among children compared to BMIP. It may be beneficial for pediatric and family physicians to measure PBF alongside BMIP to better ascertain a particular pediatric patient’s risk of T2DM. Purpose (a): The growing rate of type 2 diabetes mellitus (T2DM) in children presents a critical public health problem for the future. However, assessment of T2DM risk among children can be challenging. Therefore, to improve assessment of risk, we examined the association between BMIP (body mass index percentile, a traditional indicator) with risk, compared to the association of percent body fat (PBF) with risk. Methods (b): Data were obtained from 290 10-14 year olds in North Central Texas participating in a study examining risk for T2DM. During study visits, subjects’ BMI percentile and percent body fat were obtained using a Tanita body composition device. Associations were then assessed using logistic regression models against four of the five critical risk factors for T2DM: Average blood pressure (BP) above 95th percentile or History of high BP, family history of type 2 diabetes mellitus, positive sign of Acanthosis nigricans and a high blood sugar test. Results (c): Among 290 subjects, 78.2% were of Hispanic origin, with approximately 13.4% being Black. Approximately 51% of subjects were female, while age distribution was evenly spread across 10-14. Logistic regression models found that both PBF and BMIP were significantly associated with Acanthosis nigricans (PBF: Sβ 0.584 vs. BMIP: Sβ 0.489), average systolic BP above 95th percentile (PBF: Sβ 0.219 vs. BMIP: Sβ 0.124), family history of T2DM (PBF: Sβ 0.189 vs. BMIP: Sβ 0.172), and high blood sugar test (PBF: Sβ 0.152 vs. BMIP: Sβ 0.119). Conclusions (d): The data from this study provides evidence that PBF may be a better measurement of T2DM risk among children compared to BMIP. It may be beneficial for pediatric and family physicians to measure PBF alongside BMIP to better ascertain a particular pediatric patient’s risk of T2DM.Item PARENT'S PERCEPTIONS OF NEIGHBORHOOD SAFETY AND RISK OF TYPE 2 DIABETES IN MEXICAN AMERICAN CHILDREN AND ADOLESCENTS(2014-03) Ramirez, Roberto C.; Fulda, Kimberly; Lee, Michelle; Proffitt Leyva, Randi; Franks, Susan; Espinoza, AnnaWe conducted a study with Mexican American children and their parents and found that having playgrounds in the child's neighborhood lowers the risk of having type 2 diabetes. Purpose (a): The number of people suffering from type 2 diabetes (2 DM) has increased drastically over the last 30 years, especially in children under the age of 18. Specifically, Mexican American children have been diagnosed at alarming rates. Inactivity in children has contributed to these high rates of diabetes, but there is not sufficient information on factors that contribute to this inactivity. The purpose of this study was to explore parent’s perceptions of the features in their neighborhoods and its safety as it relates to their child being at risk of developing 2 DM. Methods (b): 144 Mexican American participants, ages 10-14 were enrolled in this study which included one visit that lasted approximately two hours. The primary caregiver was asked via a survey to assess the features and safety of the neighborhood in which the child participant lives. A set of measurements and family history were taken on each participant. “High-risk” status was assigned if participants had ≥3 of the following risk factors: BMI ≥95 percentile, high blood glucose, presence of Acanthosis Nigricans, family history of 2 DM in a 1st or 2nd degree relative, and history of hypertension or blood pressure ≥95th percentile. Simple and multiple logistic regressions were performed with high risk status for 2 DM as the outcome variable and neighborhood safety, presence of sidewalks and playgrounds in neighborhoods as the primary predictors. The adjusted model controlled for child’s age, gender, highest education level of household and household income. Results (c): Adjusted analyses illustrate that the presence of playgrounds in the respondent’s neighborhoods presented a 76% decreased odds of being at risk for 2 DM [OR: 0.24; 95% CI (0.06-0.86)]. The parent’s perceptions of neighborhood safety and the presence of sidewalks were not significant findings. In secondary findings, participants who responded that Spanish was the primary language spoken in the home had 79% decreased odds of being at risk for 2 DM [OR: 0.21; 95% CI (0.11-1.35)]. Conclusions (d): Potential policy implications resulting from the analysis of the study point to an increase in potential support for the establishment of playgrounds in areas that are deprived of such elements.Item THE ASSOCIATION BETWEEN ACCULTURATION AND RISK FOR TYPE 2 DIABETES IN MEXICAN-AMERICAN CHILDREN AND ADOLESCENTS(2014-03) Retana, Jos� D.; Proffitt Leyva, Randi; Fulda, Kimberly; Franks, SusanThe Association between Acculturation and Risk for Type 2 Diabetes in Mexican-American Children and Adolescents Purpose/Intro: Type 2 diabetes mellitus (DM2) is increasing in children and adolescents of all races/ethnicities in the United States, but especially in minorities such as Hispanics. In particular, Mexican-American children and adolescents are experiencing onset of DM2 at alarming rates. The purpose of this study was to examine the relationship between acculturation to a Mexican or Anglo orientation and risk for DM2. Methods: Participants completed demographic questions and the brief Acculturation Rating Scale for Mexican Americans II (Brief ARSMA-II). A linear acculturation score was derived from the Mexican Oriented Scale (MOS) and the Anglo Oriented Scale (AOS). Adolescents 10-14 years and a parent/legal guardian were included. At risk for DM2 was determined by having ≥3 of the following: relative with diabetes, BMI 95th percentile, blood pressure 95th percentile, elevated glucose, or positive for Acanthosis Nigricans. Simple and multiple logistic regressions were performed with risk of DM2 (high/low) as the outcome and acculturation score as the primary predictor. The adjusted model controlled for child’s age, gender, highest household education, child and maternal birth country (US/not US). Results: Participants (N=144) were 49% female and 51% male. The mean age was 11.96 years (SD=1.45). Forty-five children/adolescents (31.3%) had 3 of 5 risk factors for DM2. Approximately half (53.3%) of high risk children/adolescents were “strongly Anglo-oriented” and “Assimilated”. Higher acculturation was associated with an increased odds of being high risk for DM2 [OR=1.50; 95% CI (1.00-2.25)] Conclusions: For each degree of increased Anglo acculturation, risk for DM2 increased by 50%. Therefore, children of Mexican descent are more at risk for DM2 as they/their families become more acculturated to the Anglo cultural orientation. The degree of acculturation of a child/family should be taken into consideration when developing diabetes preventions and interventions.