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. 2009 Feb;32(2):342-7.
doi: 10.2337/dc08-1128. Epub 2008 Oct 28.

Prevalence of pre-diabetes and its association with clustering of cardiometabolic risk factors and hyperinsulinemia among U.S. adolescents: National Health and Nutrition Examination Survey 2005-2006

Chaoyang Li  1 , Earl S Ford, Guixiang Zhao, Ali H Mokdad
Affiliations

Prevalence of pre-diabetes and its association with clustering of cardiometabolic risk factors and hyperinsulinemia among U.S. adolescents: National Health and Nutrition Examination Survey 2005-2006

Chaoyang Li et al. Diabetes Care. 2009 Feb.

Abstract

Objective: Impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT) are considered to constitute "pre-diabetes." We estimated the prevalence of IFG, IGT, and pre-diabetes among U.S. adolescents using data from a nationally representative sample.

Research design and methods: We analyzed data from participants aged 12-19 years in the National Health and Nutrition Examination Survey 2005-2006. We used fasting plasma glucose and 2-h glucose during an oral glucose tolerance test to assess the prevalence of IFG, IGT, and pre-diabetes and used the log-binomial model to estimate the prevalence ratios (PRs) and 95% CIs.

Results: The unadjusted prevalences of IFG, IGT, and pre-diabetes were 13.1, 3.4, and 16.1%, respectively. Boys had a 2.4-fold higher prevalence of pre-diabetes than girls (95% CI 1.3-4.3). Non-Hispanic blacks had a lower rate than non-Hispanic whites (PR 0.6, 95% CI 0.4-0.9). Adolescents aged 16-19 years had a lower rate than those aged 12-15 years (0.6, 0.4-0.9). Overweight adolescents had a 2.6-fold higher rate than those with normal weight (1.3-5.1). Adolescents with two or more cardiometabolic risk factors had a 2.7-fold higher rate than those with none (1.5-4.8). Adolescents with hyperinsulinemia had a fourfold higher prevalence (2.2-7.4) than those without. Neither overweight nor number of cardiometabolic risk factors was significantly associated with pre-diabetes after adjustment for hyperinsulinemia.

Conclusions: Pre-diabetes was highly prevalent among adolescents. Hyperinsulinemia was independently associated with pre-diabetes and may account for the association of overweight and clustering of cardiometabolic risk factors with pre-diabetes.

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Figures

Figure 1
Figure 1
Prevalence of IFG, IGT, and pre-diabetes according to the number of cardiometabolic risk factors (A) (*P < 0.05, compared with the 0 group; †P < 0.01, compared with the 1 group; ‡P < 0.10, compared with the 0 group), and a combination of central obesity and hyperinsulinemia (B) (*P < 0.05, compared with the OB−/HI− group; †P < 0.05 compared with the OB+/HI− group). OB, central obesity; HI, hyperinsulinemia, defined as >75th percentile of fasting insulin (82.5 pmol/l or 13.75 μU/ml) by the Mercodia method. To convert fasting insulin (FI) between the Mercodia and the Tosoh methods, see footnote ‖ to Table 1.
Figure 2
Figure 2
Geometric means and 95% CIs of fasting insulin (picomoles per liter, Mercodia method) (A) and HOMA (B) among U.S. adolescents, ages 12–19, by IFG, IGT, and pre-diabetes status (n = 777).
See this image and copyright information in PMC

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