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青少年和青年 2 型糖尿病近期发病患者的特征:TODAY 队列的基线特征。

Characteristics of adolescents and youth with recent-onset type 2 diabetes: the TODAY cohort at baseline.

机构信息

University of Oklahoma College of Medicine, 1200 North Phillips, Suite 4500, Oklahoma City, Oklahoma 73104.

出版信息

J Clin Endocrinol Metab. 2011 Jan;96(1):159-67. doi: 10.1210/jc.2010-1642. Epub 2010 Oct 20.

Abstract

CONTEXT

The Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) cohort represents the largest and best-characterized national sample of American youth with recent-onset type 2 diabetes.

OBJECTIVE

The objective of the study was to describe the baseline characteristics of participants in the TODAY randomized clinical trial.

DESIGN

Participants were recruited over 4 yr at 15 clinical centers in the United States (n = 704) and enrolled, randomized, treated, and followed up 2-6 yr.

SETTING

The study was conducted at pediatric diabetes care clinics and practices.

PARTICIPANTS

Eligible participants were aged 10-17 yr inclusive, diagnosed with type 2 diabetes for less than 2 yr and had a body mass index at the 85th percentile or greater.

INTERVENTIONS

After baseline data collection, participants were randomized to one of the following groups: 1) metformin alone, 2) metformin plus rosiglitazone, or 3) metformin plus a lifestyle program of weight management.

MAIN OUTCOME MEASURES

Baseline data presented include demographics, clinical/medical history, biochemical measurements, and clinical and biochemical abnormalities.

RESULTS

At baseline the cohort included the following: 64.9% were female; mean age was 14.0 yr; mean diabetes duration was 7.8 months; mean body mass index Z-score was 2.15; 89.4% had a family history of diabetes; 41.1% were Hispanic, 31.5% were non-Hispanic black; 38.8% were living with both biological parents; 41.5% had a household annual income of less than $25,000; 26.3% had a highest education level of parent/guardian less than a high school degree; 26.3% had a blood pressure at the 90th percentile or greater; 13.6% had a blood pressure at the 95th percentile or greater; 13.0% had microalbuminuria; 79.8% had a low high-density lipoprotein level; and 10.2% had high triglycerides.

CONCLUSIONS

The TODAY cohort is predominantly from racial/ethnic minority groups, with low socioeconomic status and a family history of diabetes. Clinical and biochemical abnormalities and comorbidities are prevalent within 2 yr of diagnosis. These findings contribute greatly to our understanding of American youth with type 2 diabetes.

摘要

背景

青少年和青年的糖尿病治疗选择(TODAY)队列代表了美国最近被诊断患有 2 型糖尿病的青少年中最大和最具代表性的全国性样本。

目的

本研究的目的是描述 TODAY 随机临床试验参与者的基线特征。

设计

参与者在美国 15 个临床中心招募了 4 年(n = 704),并进行了登记、随机分组、治疗和随访 2-6 年。

地点

该研究在儿科糖尿病护理诊所和实践中进行。

参与者

符合条件的参与者年龄在 10-17 岁之间,确诊为 2 型糖尿病不到 2 年,体重指数在第 85 百分位或以上。

干预措施

在基线数据收集后,参与者被随机分为以下三组之一:1)单独使用二甲双胍,2)二甲双胍加罗格列酮,或 3)二甲双胍加体重管理的生活方式计划。

主要观察指标

呈现的基线数据包括人口统计学、临床/医学史、生化测量值以及临床和生化异常。

结果

在基线时,该队列包括以下内容:64.9%为女性;平均年龄为 14.0 岁;平均糖尿病病程为 7.8 个月;平均体重指数 Z 评分 2.15;89.4%有糖尿病家族史;41.1%为西班牙裔,31.5%为非西班牙裔黑人;38.8%与亲生父母同住;41.5%家庭年收入低于 25000 美元;26.3%父母/监护人最高教育程度低于高中学历;26.3%血压处于第 90 百分位或以上;13.6%血压处于第 95 百分位或以上;13.0%有微量白蛋白尿;79.8%低高密度脂蛋白水平;10.2%高甘油三酯。

结论

TODAY 队列主要来自种族/少数民族群体,社会经济地位较低,有糖尿病家族史。在确诊后 2 年内,临床和生化异常及合并症普遍存在。这些发现极大地帮助我们了解美国的青少年 2 型糖尿病患者。

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