The prevalence of overweight children and rates of type 2 diabetes in children have risen significantly over the past decade. Insulin resistance is a component of both diseases.
Specific aims . The specific aims of this study were: (1) Determine the prevalence of "overweight" and "risk for overweight" according to Body Mass Index among a group of elementary school-age children. (2) Document the prevalence of AN and risk factors associated with type 2 diabetes in the same group of children. (3) Determine the percentage of school-age children who are eligible for type 2 diabetes screening. (4) Test a quantitative AN tool for use in elementary school-age children of various ethnic groups.
Methods . A cross-sectional design was used to review 1164 school-based clinic medical records of elementary school-age children. Relationships between ethnicity, gender, age, family history of diabetes, presence of AN, and Body Mass Index were examined.
Inter-rater reliability of a quantitative AN screening tool was evaluated for use in elementary school-age children of various ethnic groups. A subset of 57 students was selected.
Results . Of the students screened, 39% had a Body Mass Index above the 85th percentile for age and sex; 22% of the students were overweight. Acanthosis nigricans was identified in 25.7% of the students and 48.5% of the students identified a family history of diabetes. According to recognized screening guidelines for type 2 diabetes in children, 32.6% of the participants were eligible for further type 2 diabetes screening.
Inter-rater concordance found total agreement 57% of the time. All clinicians were within one AN grade of each other 95% of the time. The clinicians were more consistent in grading AN in children with higher Body Mass Index and more severe degrees of AN. No ethnic or gender difference was found in the grading of AN and the use of the screening tool.
Conclusions . Rates of overweight, risk for overweight, and AN among children in this study exceeded national reported estimates. Students in high-risk ethnic groups had higher rates of AN and rates increased as Body Mass Index increased regardless of age or sex. Nearly one-third of students were eligible for further type 2 diabetes screening.
The quantitative AN screening tool was an easy-to-use, reliable screening tool for use in children of various ethnic groups. Prevention and early intervention strategies are key to reducing the morbidity of these serious health consequences in early adulthood.
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