Overweight, obesity and impaired glucose tolerance are independent predictors of incident diabetes over 20 years in Native American children, whereas other components of metabolic syndrome, including elevated blood pressure and cholesterol, are not, according to a recent study.
“Overweight or overweight plus IGT during childhood or adolescence predicted an increased incidence of diabetes up to 25 years after the baseline examination,” Kevin M. Wheelock, an NIH postbaccalaureate research fellow at the National Institute of Diabetes and Digestive and Kidney Diseases in Phoenix, and colleagues wrote. “Even in children aged 5 to 11 years, a BMI above the 85th percentile and/or IGT were risk factors for diabetes in adulthood, suggesting that interventions should be considered in young children presenting with metabolic abnormalities as well as in older children.”
In a prospective cohort study, researchers analyzed data from 5,532 children from the Gila River Indian community in Arizona without diabetes aged 5 to 19 years, followed between 1965 and 2007 for the development of diabetes. Baseline measurements included BMI, BP, serum cholesterol and 2-hour plasma glucose following an oral glucose tolerance test. For additional analyses, researchers divided children by baseline age (5-11 years and 12-19 years). Children with overweight and IGT, as well as children with overweight, IGT and at least two components of metabolic syndrome had the highest 20-year cumulative incidence of diabetes (79% and 76%, respectively), followed by children without overweight but with IGT (34%) and children with overweight and IGT (28%), according to researchers. Children without overweight or IGT had the lowest 20-year incidence of diabetes (9.5%).
Incident rate ratios for children with overweight and IGT or metabolic components and IGT were higher in children aged 5 to 11 years than children aged 12 to 19 years during the first 5 years of follow-up; after 5 years, ratios became comparable between the groups, the researchers wrote.
After adjustment for age, sex and other metabolic factors, BMI and 2-hour glucose strongly predicted incident diabetes, whereas mean arterial pressure and cholesterol level did not. – by Regina Schaffer
The researchers report no relevant financial disclosures.