Response heterogeneity to lifestyle intervention among Latino adolescents

Armando Peña, Daniel McNeish, Stephanie L. Ayers, Micah L. Olson, Kiley B. Vander Wyst, Allison N. Williams, Gabriel Q. Shaibi

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To characterize the heterogeneity in response to lifestyle intervention among Latino adolescents with obesity. Methods: We conducted secondary data analysis of 90 Latino adolescents (age 15.4 ± 0.9 y, female 56.7%) with obesity (BMI% 98.1 ± 1.5%) that were enrolled in a 3 month lifestyle intervention and were followed for a year. Covariance pattern mixture models identified response phenotypes defined by changes in insulin sensitivity as measured using a 2 hour oral glucose tolerance test. Baseline characteristics were compared across response phenotypes using one-way ANOVA and chi-square test. Results: Three distinct response phenotypes (PH1, PH2, PH3) were identified. PH1 exhibited the most robust response defined by the greatest increase in insulin sensitivity over time (β ± SE, linear 0.52 ± 0.17, P <.001; quadratic −0.03 ± 0.01, P =.001). PH2 showed non-significant changes, while PH3 demonstrated modest short-term increases in insulin sensitivity which were not sustained over time (linear 0.08 ± 0.03, P =.002; quadratic −0.01 ± 0.002, P =.003). At baseline, PH3 (1.1 ± 0.4) was the most insulin resistant phenotype and exhibited the highest BMI% (98.5 ± 1.1%), 2 hours glucose concentrations (144.0 ± 27.5 mg/dL), and lowest beta-cell function as estimated by the oral disposition index (4.5 ± 2.8). Conclusion: Response to lifestyle intervention varies among Latino youth with obesity and suggests that precision approaches are warranted to meet the prevention needs of high risk youth.

Original languageEnglish (US)
Pages (from-to)1430-1436
Number of pages7
JournalPediatric Diabetes
Volume21
Issue number8
DOIs
StatePublished - Dec 1 2020

Keywords

  • diabetes prevention
  • insulin resistance
  • non-responder
  • precision medicine
  • responder

ASJC Scopus subject areas

  • Internal Medicine
  • Pediatrics, Perinatology, and Child Health
  • Endocrinology, Diabetes and Metabolism

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