Department of Internal Medicine, College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska 68198-4085, USA.
Int J Obes (Lond). 2013 Apr;37(4):540-5. doi: 10.1038/ijo.2012.199. Epub 2012 Dec 11.
Early identification of pre-diabetes and insulin resistance (IR) provides an important window of opportunity for diabetes prevention. Little is known about the prevalence of pre-diabetes and IR in Native American (NA) youth. We designed a cross-sectional, community-based study of NA children to estimate the prevalence of diabetes, pre-diabetes and IR and their association with other diabetes risk factors.
NA children (5-18 years) were screened with body mass index (BMI), blood pressure, oral glucose tolerance test (OGTT), lipids, insulin and highly sensitive C-reactive protein (hsCRP), and calculated homeostatic model assessment of IR (HOMA-IR).
Mean age of the cohort (n=201) was 10.8 ± 3.8 years (± s.d.; 94/107 M/F). BMI percentile for age and sex (BMI%) was elevated (≥ 85 th percentile) in 58.6% of 5-11 years and 51.1% of 12-18 years, and positively correlated with HOMA-IR, blood pressure, triglycerides and hsCRP (P<0.05). The prevalence rate for pre-diabetes and diabetes were 6.5% (3.5-10.8%) and 1.0% (0.1-3.6%), respectively. Mean HOMA-IR was greater in the older than younger age group while prevalence of pre-diabetes was the same. Those with pre-diabetes and diabetes had a greater HOMA-IR, abdominal circumference and BMI% than normal youth.
In the first prospective, community-based screening for pre-diabetes, IR and diabetes in United States NA youth using OGTT, while the number of diabetes cases was low, pre-diabetes was found in a significant number of youth, particularly in those with BMI ≥ 95 th%. As proportions of pre-diabetes were similar in 5-11 and 12-18 year olds, diabetes risk begins early in NA youth.
早期识别糖尿病前期和胰岛素抵抗（IR）为糖尿病预防提供了一个重要的机会窗口。关于美国原住民（NA）青少年中糖尿病前期和 IR 的患病率知之甚少。我们设计了一项基于社区的 NA 儿童横断面研究，以估计糖尿病、糖尿病前期和 IR 的患病率及其与其他糖尿病危险因素的关系。
对 NA 儿童（5-18 岁）进行了身体质量指数（BMI）、血压、口服葡萄糖耐量试验（OGTT）、血脂、胰岛素和高敏 C 反应蛋白（hsCRP）筛查，并计算了胰岛素抵抗的稳态模型评估（HOMA-IR）。
队列的平均年龄（n=201）为 10.8±3.8 岁（±标准差；94/107M/F）。5-11 岁和 12-18 岁儿童中，BMI 年龄和性别百分位数（BMI%）升高（≥85 百分位数）分别为 58.6%和 51.1%，与 HOMA-IR、血压、三酰甘油和 hsCRP 呈正相关（P<0.05）。糖尿病前期和糖尿病的患病率分别为 6.5%（3.5-10.8%）和 1.0%（0.1-3.6%）。年龄较大的儿童的平均 HOMA-IR 高于年龄较小的儿童，而糖尿病前期的患病率相同。患有糖尿病前期和糖尿病的儿童的 HOMA-IR、腰围和 BMI% 均高于正常儿童。
在美国 NA 青少年中，使用 OGTT 进行了首次针对糖尿病前期、IR 和糖尿病的前瞻性、基于社区的筛查，虽然糖尿病的病例数较少，但大量青少年存在糖尿病前期，尤其是 BMI≥95 百分位的青少年。由于 5-11 岁和 12-18 岁儿童的糖尿病前期比例相似，因此糖尿病风险在 NA 青少年中很早就开始了。
