Weinstock Ruth S, Trief Paula M, El Ghormli Laure, Goland Robin, McKay Siripoom, Milaszewski Kerry, Preske Jeff, Willi Steven, Yasuda Patrice M
State University of New York Upstate Medical University, Syracuse, NY.
George Washington University Biostatistics Center, Rockville, MD
Diabetes Care. 2015 May;38(5):784-92. doi: 10.2337/dc14-2393. Epub 2015 Mar 17.
This study examined parental factors associated with outcomes of youth in the Treatment Options for type 2 Diabetes in Adolescents and Youth (TODAY) clinical trial.
Of 699 youth with type 2 diabetes in the TODAY cohort, 623 (89.1%) had a parent participate and provide data at baseline, including weight, HbA1c, blood pressure, symptoms of depression, binge eating (BE), and medical history. Youth were followed 2-6.5 years. Data were analyzed using regression models and survival curve methods.
Parental diabetes (43.6% of parents) was associated with higher baseline HbA1c (P < 0.0001) and failure of youths to maintain glycemic control on study treatment (53.6% vs. 38.2% failure rate among those without a diabetic parent, P = 0.0002). Parental hypertension (40.6% of parents) was associated with hypertension in youth during TODAY (40.4% vs. 27.4% of youth with and without parental hypertension had hypertension, P = 0.0008) and with higher youth baseline BMI z scores (P = 0.0038). Parents had a mean baseline BMI of 33.6 kg/m(2). Parental obesity (BMI >30 kg/m(2)) was associated with higher baseline BMI z scores in the youth (P < 0.0001). Depressive symptoms in parents (20.6% of parents) were related to youth depressive symptoms at baseline only (P = 0.0430); subclinical BE in parents was related to the presence of subclinical BE (P = 0.0354) and depressive symptoms (P = 0.0326) in youth throughout the study period.
Parental diabetes and hypertension were associated with lack of glycemic control, hypertension, and higher BMI z scores in youth. Further research is needed to better understand and address parental biological and behavioral factors to improve youth health outcomes.
本研究调查了青少年2型糖尿病治疗选择（TODAY）临床试验中与青少年预后相关的父母因素。
在TODAY队列的699名2型糖尿病青少年中，623名（89.1%）的父母参与并在基线时提供了数据，包括体重、糖化血红蛋白（HbA1c）、血压、抑郁症状、暴饮暴食（BE）和病史。对青少年进行了2 - 6.5年的随访。使用回归模型和生存曲线方法对数据进行分析。
父母患有糖尿病（43.6%的父母）与较高的基线HbA1c相关（P < 0.0001），且青少年在研究治疗中未能维持血糖控制（糖尿病父母组的失败率为53.6%，非糖尿病父母组为38.2%，P = 0.0002）。父母患有高血压（40.6%的父母）与青少年在TODAY期间患高血压相关（有和无父母高血压的青少年中患高血压的比例分别为40.4%和27.4%，P = 0.0008），并与青少年较高的基线体重指数（BMI）z评分相关（P = 0.0038）。父母的平均基线BMI为33.6kg/m²。父母肥胖（BMI > 30kg/m²）与青少年较高的基线BMI z评分相关（P < 0.0001）。父母的抑郁症状（20.6%的父母）仅与青少年基线时的抑郁症状相关（P = 0.0430）；在整个研究期间，父母的亚临床暴饮暴食与青少年的亚临床暴饮暴食（P = 0.0354）和抑郁症状（P = 0.0326）相关。
父母患有糖尿病和高血压与青少年血糖控制不佳、高血压和较高的BMI z评分相关。需要进一步研究以更好地理解和解决父母的生物学和行为因素，从而改善青少年的健康预后。
