Background. Little information is available on tracking of glucose or insulin. The phenomenon known as tracking, defined as the maintenance of relative rank with respect to peers over time, is important in the early identification of individuals who may be at highest risk of metabolic disorders. Previous studies indicate that the tracking phenomenon may be most useful for anthropometric variables, slightly less so for lipids, and lowest for blood pressure Methods. Serial, cross-sectional data collected from 1976 to 2001 as part of the Bogalusa Heart Study were combined to create a longitudinal cohort of individuals with at least one measurement before, and one after, age 18 years. Tracking was assessed by correlations, percentiles, GEE, and mixed models regression analyses for fasting glucose, insulin, and homeostasis model assessment (HOMA) Results. Fasting measurements were available for 2,533 and 1,434 individuals for glucose and insulin/HOMA, respectively. Mean follow-up age was 25--27 (+/-5) years. Average blood pressure and lipid values were in the normal range in adulthood. Mean body mass index (BMI) was 27 +/- 7 kg/m2. Correlations ranged from 0.16--0.22 for glucose, 0.24--0.31 for insulin, and 0.24--0.30 for HOMA (p < 0.0001 for all). The percent of individuals remaining in the top quintile for glucose was 25--34%, and 30--41% remained in the top quintile for insulin during adulthood. Analyses by GEE regression indicated that mean values of outcomes were significantly different for each measurement age group. Mixed models analysis indicated significant random variability in slopes of the lines for glucose and insulin, but not for HOMA. Multiple measurements over time accounted for 27%, 8% and 19% of the variation in glucose, insulin, and HOMA, respectively Conclusions. This study supports the hypothesis that fasting glucose, insulin, and HOMA follow a tracking phenomenon from childhood to adulthood. A strong association was found for all three outcomes by multiple analyses. The tracking relationship was stronger for insulin than glucose, and HOMA offered no advantage with regard to tracking over insulin alone. This information may be useful to help identify, early in life, those at highest risk of future metabolic disorders / acase@tulane.edu
| Identifer | oai:union.ndltd.org:TULANE/oai:http://digitallibrary.tulane.edu/:tulane_24852 |
| Date | January 2003 |
| Contributors | Kieltyka, Roberta Lyn (Author), Sherwin, Roger (Thesis advisor) |
| Publisher | Tulane University |
| Source Sets | Tulane University |
| Language | English |
| Detected Language | English |
| Rights | Access requires a license to the Dissertations and Theses (ProQuest) database., Copyright is in accordance with U.S. Copyright law |
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