Berhan Yonas T, Möllsten Anna, Carlsson Annelie, Högberg Lotta, Ivarsson Anneli, Dahlquist Gisela
Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden.
Acta Paediatr. 2014 Oct;103(10):1078-82. doi: 10.1111/apa.12729. Epub 2014 Sep 10.
Childhood obesity is now an established public health problem in most developed countries, and there is concern about a parallel increase of type 2 diabetes. The aim of this study was to estimate the prevalence of undiagnosed type 2 diabetes in overweight Swedish school children from 11 to 13 years of age.
Body mass index (BMI) was measured in 5528 schoolchildren in the 6th grade, from 11 to 13 years of age, in five different regions in Sweden. Overweight was defined by international age- and sex-specific BMI cut-offs, corresponding to adult BMI cut-offs of 25 kg/m(2) at 18 years of age (ISO-BMI ≥25, n = 1275). Haemoglobin A1c (HbA1c) was measured in 1126 children with ISO-BMI ≥25. Children with a Diabetes Control and Complications Trial aligned HbA1c ≥6.1% on two occasions underwent an oral glucose tolerance test (OGTT) to establish the diabetes diagnosis.
Of 1126 children with ISO-BMI ≥25, 24 (2.1%) had at least one HbA1c value ≥6.1%. Three of them had HbA1c ≥6.1% on two occasions, and all of them had a normal OGTT.
In this cross-sectional, population-based screening study of a high-risk group of 11- to 13-year-old Swedish school children, we found no indication of undiagnosed diabetes or impaired glucose tolerance.
儿童肥胖如今在大多数发达国家已成为一个既定的公共卫生问题,人们也担心2型糖尿病会随之增加。本研究的目的是估计11至13岁超重瑞典学童中未被诊断出的2型糖尿病的患病率。
对瑞典五个不同地区11至13岁六年级的5528名学童测量了体重指数(BMI)。超重的定义采用国际年龄和性别特异性BMI临界值,相当于18岁时成人BMI临界值25kg/m²(国际标准BMI≥25,n = 1275)。对1126名国际标准BMI≥25的儿童测量了糖化血红蛋白(HbA1c)。两次糖化血红蛋白水平符合糖尿病控制与并发症试验标准且≥6.1%的儿童接受口服葡萄糖耐量试验(OGTT)以确诊糖尿病。
在1126名国际标准BMI≥25的儿童中,24名(2.1%)至少有一次HbA1c值≥6.1%。其中3名儿童两次HbA1c≥6.1%,且他们的口服葡萄糖耐量试验结果均正常。
在这项针对11至13岁瑞典高危学童群体的横断面、基于人群的筛查研究中,我们未发现未被诊断出的糖尿病或糖耐量受损的迹象。