Arlyn G. Riskind     
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Email: ariskind@endo-society.org

Aaron Lohr
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Compared with whites and Mexican-Americans, black youths who have a cluster of risk factors for diabetes and heart disease have a higher degree of a marker for inflammation in the blood which makes them likelier to develop cardiovascular disease as adults. This finding is from a new study to be presented Sunday at The Endocrine Society’s 92nd Annual Meeting in San Diego.

The inflammation marker—C-reactive protein—is higher in people with the metabolic syndrome, a group of problems with blood glucose (sugar), blood pressure and cholesterol often seen in prediabetes.

“However, there hasn’t been previous evidence that one ethnic group with the metabolic syndrome has more inflammation,” said Mark DeBoer, MD, the study’s lead author and an assistant professor at the University of Virginia, Charlottesville. “This is notable because individuals with worsened inflammation are more likely to develop heart disease and may benefit from earlier treatment.”

Using a nationally representative database, the National Health and Nutrition Examination Survey (NHANES), the researchers studied data from 2,733 individuals ages 12 to 18 years who did not have diabetes and who identified themselves as non-Hispanic whites, non-Hispanic blacks and Mexican-Americans. Investigators then determined the percentage in each ethnic group that had the metabolic syndrome, defined as having any three of the following: a large waistline, low HDL (“good”) cholesterol, high triglycerides (fats in the blood), high blood pressure and high fasting blood sugar. The National Institute of Diabetes and Digestive and Kidney Diseases helped fund the study.

As in other studies, blacks had a lower rate of the metabolic syndrome: 4.3 percent versus 8.9 percent for whites and 9.6 percent for Mexican-Americans. In all ethnic groups, levels of C-reactive protein were higher in those with the metabolic syndrome than those without. However, blacks with the metabolic syndrome had an average C-reactive protein level more than 50 percent higher than that in either of the other ethnic groups, the authors reported.

“This worsened inflammation in blacks begins to occur at a young age,” DeBoer said.

He believes that clinicians should stratify risk in their patients with the metabolic syndrome, targeting those at particularly high risk of heart disease and diabetes to have early intensive intervention. Black adolescents with the metabolic syndrome should probably be considered at higher risk, according to DeBoer.

“This study should serve as a motivator for both the [high-risk] patient and the clinician to modify the patient’s diet and increase exercise level,” he said.

 

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Founded in 1916, The Endocrine Society is the world's oldest, largest, and most active organization devoted to research on hormones and the clinical practice of endocrinology. Today, The Endocrine Society's membership consists of over 14,000 scientists, physicians, educators, nurses and students in more than 80 countries. Together, these members represent all basic, applied, and clinical interests in endocrinology. The Endocrine Society is based in Chevy Chase, Md. To learn more about the Society, and the field of endocrinology, visit our web site at www.endo-society.org.