No abstract

Background-Fat distribution is well recognized as a cardiovascular risk factor in adults. The association between android fat distribution and cardiovascular risk factors, such as blood pressure (BP), was previously reported in an African-American and Caucasian pediatric population. The aim of the present study was to investigate the relationship between BP and body fat distribution in a large cross-sectional pediatric sample. The effects of race, sex, and puberty on this relationship were assessed. Methods and Results-BP was measured in 920 healthy children and adolescents (African-American, Asian, and Caucasian, ages 5 to 18 years). Fat distribution was determined by skinfold thickness and dual-energy X-ray absorptiometry (DXA). Pubertal status was assessed by the criteria of Tanner. Regression analysis was used to explore the association between BP and fat distribution. Significant positive relationships between systolic and diastolic BP and trunk fat adjusted for total fat were seen in boys at all pubertal stages in all 3 races by both DXA and skinfold measurements. In girls, trunk fat was not a significant predictor of BP. Conclusions-Our results demonstrate a sex difference in the relationship between BP and trunk fat in that a significant positive relationship was present in boys only. These findings, based on 2 independent measures of fat distribution, may help identify the specific features of individuals at risk, allow earlier intervention, and suggest sex-specific determinants for BP.

An increased prevalence of Type 1 (insulin-dependent) diabetes has been reported in patients with congenital rubella. Rubella virus multiplies in the pancreas, and we have hypothesized that studies of children with congenital rubella would be of great importance in following the development of Type 1 diabetes in a defined, susceptible population. Two hundred and forty-one children with congenital rubella (mean age 17.4 +/- 0.3 years; 65% black and hispanic) have been evaluated, 30 of whom already have diabetes and 17 of whom have borderline glucose tolerance. In these latter two groups, HLA-DR3 is significantly increased and HLA-DR2 significantly decreased. Pancreatic islet cell cytotoxic surface antibodies are found in 20% of the total congenital rubella population, including in more than 50% in the time period before they develop diabetes and are not related to any specific HLA type. In addition, anti-microsomal and anti-thyroglobulin antibodies are found in 34% of this population. The data demonstrate that Type 1 diabetes developing in congenital rubella patients has the genetic and immunological features of classical Type 1 diabetes, namely the presence of HLA-DR3, the absence of HLA-DR2, islet cell surface antibodies before decompensation and an increased prevalence of anti-thyroid antibodies. Patients with non-diabetic congenital rubella represent an easily identifiable group in whom other immunological factors associated with Type 1 diabetes can be elucidated and possibly modified.