Metabolic Differences of Overweight Children and Children of Overweight Parents

This study is currently recruiting patients.

Sponsored by

National Institute of Child Health and Human Development (NICHD)

Purpose

This study focuses on the way weight is gained. Individuals who gain weight primarily in their midsection (visceral weight) are at an increased risk for developing diabetes and high blood pressure. Research has shown that African Americans suffer more often from high blood pressure, diabetes (non-insulin dependent), and heart disease than Caucasian Americans. These conditions lead to significant numbers of deaths and diseases associated with and made worse by obesity. African American women in particular suffer from obesity and the associated conditions of obesity more than any other race or gender. However, it is unknown if the conditions seen in African American women are a result of the obesity or differences in their insulin sensitivity, glucose disposal, or fat metabolism. This study will compare body composition, total and resting energy expenditure, and glucose disposal of obese African American and Caucasian children and of non-obese children of obese African American and Caucasian parents, to characterize the timing and nature of factors that may contribute to the prevalence of obesity and its complications. Patients participating in this study will be followed for 15 years and be evaluated every 5 years during the study.

Study Type: Natural History

Official Title: Population Differences in the Insulin Sensitivity, Resting Energy Expenditure, and Body Composition of Overweight Children and Children of Overweight Parents

Further Study Details: African Americans have a greater prevalence than Caucasian Americans of hypertension, non-insulin-dependent diabetes mellitus, and cardiovascular disease. These conditions lead to substantial excess morbidity and mortality and is associated with and exacerbated by obesity, the prevalence of which is strikingly elevated in African American women. It is unknown if this increased prevalence of comorbid conditions is related to the greater prevalence of severe obesity among African American women, or due to differences in insulin sensitivity, glucose disposal, or fat cell metabolism. Our studies of normal weight children have found a correlation of the subcutaneous adipose tissue depot with insulin levels before and after an oral glucose tolerance test only in African Americans. It is not known whether these findings are verified with more accurate measures of insulin sensitivity and glucose disposal. It is similarly unknown whether these differences are found in already obese children or in children at high risk for developing obesity. We will compare body composition, total and resting energy expenditure, and glucose disposal of obese African American and Caucasian children and of non-obese children of obese African American and Caucasian parents, to characterize the timing and nature of factors that may contribute to the prevalence of obesity and its complications. We will also relate serum levels of the body-fat related circulating factors such as leptin, to these measures, and obtain blood for genomic DNA isolation from participants and their parents to characterize the roles of genes felt important for the development of obesity. We will then follow these children for 15 years, studying them intensively at 5 year intervals until adulthood.  

Eligibility

Genders Eligible for Study:  Both Criteria

Good General Health.

No individuals with renal, hepatic, most endocrinologic (e.g. hypothyroidism, or Cushing syndrome), or pulmonary disorders (other than mild asthma not requiring chronic medication).

Obese subjects will have a body mass index for age above the 85th percentile.

Normal weight subjects of obese parents will have a body mass index between the 5th and 85th percentile and both parents' current body mass index above the 85th percentile, or a history of a body mass index above the 85th percentile.

No significant psychiatric illness.

Tanner I (prepubertal) or Tanner II (early pubertal) pubic hair and breast stage development for girls, and Tanner I or Tanner II pubic hair and testes size (6ml) for boys.

Ability to undergo MRI.

No volunteers with metal in their bodies that are contraindications for MRI. These include cardiac pacemakers, neural pacemakers, aneurysmal clips, shrapnel, ocular foreign bodies, cochlear implants, non-detachable electronic or electromechanical devices (such as infusion pumps, nerve stimulators, bone growth stimulators, etc.).

Age 6-10 years at the start of the study.

For girls who have been followed to an age when they are menstruating (or are of an age when pregnancy is a possibility), a negative pregnancy test.

Race of all 4 grandparents self-identified either as all Caucasian or all African American.

Location and Contact Information

Maryland

National Institute of Child Health and Human Development (NICHD), 9000 Rockville Pike   Bethesda,    Maryland,   20892,   United States; Recruiting

PRPL     Warren G. Magnuson Clinical Center National Institutes of Health   Bethesda,    Maryland,   20892-4754,   United States  1-800-411-1222    prpl@mail.cc.nih.gov  

More Information

Detailed Web Page

Publications that lead up to this study

Yanovski. 1997. Resting metabolic rate in african-american and caucasian girls, Obes Res, Vol. 5, p. 321

Yanovski. 1993. Differences in the hypothalamic-pituitary-adrenal axis of black and white women, J Clin Endocrinol Metab, Vol. 77, p. 536

Ravussin. 1993. Energy metabolism in obesity Studies in the Pima Indians, Diabetes Care, Vol. 16, p. 232

Study ID Numbers  96-CH-0101

NLM Identifier  NCT00001522

Date study started June 4, 1996

Recruitment status verified  May 26, 1999

Last Updated  May 26, 1999

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