Parental diabetes, pubertal stage, and extreme obesity are the main risk factors for prediabetes in children and adolescents: a simple risk score to identify children at risk for prediabetes

Abstract

Objectives: The current worldwide increase of prediabetes defined as impaired fasting glucose or impaired glucose tolerance and type 2 diabetes mellitus (T2DM) coincides the increase of obesity. However, it is unclear that which children have an increased risk and should be screened for prediabetes.

Methods: We studied 437 overweight children and adolescents to identify risk factors for prediabetes. A risk score for prediabetes was calculated using logistic regression. This score was examined in a second, independent cohort of 567 overweight children and adolescents. History of T2DM in parents and grandparents, degree of overweight, age, pubertal stage, birth weight, hypertension, dyslipidemia, acanthosis nigricans, and abdominal obesity were considered as potential risk factors.

Results: The frequency of prediabetes was 6% in sample 1 and 17% in sample 2. The strongest association was observed for history of parental diabetes with an adjusted odds ratio (aOR) of 9.5 [95% confidence interval (CI) 2.5-36.4] in sample 1 and 6.3 (95% CI 3.7-10.7) in sample 2, followed by pubertal stage with an aOR of 5.5 (95% CI 0.7-45.4) in sample 1 and 6.2 (95% CI 2.4-15.6) in sample 2, and by extreme obesity with an aOR of 5.0 (95% CI 1.7-15.3) in sample 1 and 3.3 (95% CI 2.0-5.4) in sample 2.

Conclusions: The main risk factors for prediabetes were parental diabetes, pubertal stage, and extreme obesity. Screening for prediabetes seems meaningful in subjects with either a parental history of diabetes or a combination of extreme obesity and pubertal stage and detected nearly 90% of the overweight children and adolescents with prediabetes.