Mirbolouk Mohammadhassan, Derakhshan Arash, Charkhchi Paniz, Guity Kamran, Azizi Fereidoun, Hadaegh Farzad
Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Cellular and Molecular Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Pediatr Diabetes. 2016 Dec;17(8):608-616. doi: 10.1111/pedi.12343. Epub 2016 Jan 14.
To evaluate the incidence and predictors of early adulthood pre-diabetes/type 2 diabetes (T2D) among Iranian adolescents during a median follow-up of 9.2 yr.
A total of 2563 subjects aged 10-19 yr, without pre-diabetes/T2D at baseline, were entered in the study. Pre-diabetes was defined as those with fasting plasma glucose (FPG) 5.6 to <7 mmol/L. T2D was defined as anti-T2D drug consumption or FPG ≥7 mmol/L. Multivariate Cox-proportional analysis was applied to examine the association between different risk factors that showed attained statistical significance < 0.2 in univariate analysis, with incident pre-diabetes/T2D. Same method was repeated on 1803 subjects with complete parental data to find the relation between parental risk factors and pre-diabetes/T2D.
The mean age of participants was 14.45 ± 2.78 yr, and 53.6% were female. During follow-up 208 cases of pre-diabetes/T2D occurred, resulting in an incidence rate of 9.61 per 1000 person-years. Multivariate-adjusted hazard ratios (HRs) for incident pre-diabetes/T2D showed significant risk for 1 standard deviation increase in FPG and body mass index with corresponding HR of 1.89 (1.6-2.23) and 1.435 (1.080-1.905), respectively. Among parental potential risk factors, the paternal history of T2D was independently associated with increased risk for pre-diabetes/T2D in the adolescence (HR = 1.63(1.02-2.60)).
About 1% of Iranian adolescents developed pre-diabetes/T2D each year. Among the non-modifiable risk factors paternal history of T2D and, among modifiable risk factors, the presence of general adiposity as well as the higher level of FPG should be considered among adolescents for development of pre-diabetes/T2D later in the young adulthood.
评估伊朗青少年在9.2年中位随访期内成年早期糖尿病前期/2型糖尿病（T2D）的发病率及预测因素。
共有2563名年龄在10 - 19岁、基线时无糖尿病前期/T2D的受试者进入本研究。糖尿病前期定义为空腹血糖（FPG）5.6至<7 mmol/L者。T2D定义为服用抗T2D药物或FPG≥7 mmol/L者。采用多变量Cox比例分析来检验单变量分析中显示统计学显著性<0.2的不同危险因素与新发糖尿病前期/T2D之间的关联。对1803名有完整父母数据的受试者重复相同方法，以找出父母危险因素与糖尿病前期/T2D之间的关系。
参与者的平均年龄为14.45±2.78岁，53.6%为女性。随访期间发生208例糖尿病前期/T2D病例，发病率为每1000人年9.61例。新发糖尿病前期/T2D的多变量调整风险比（HR）显示，FPG和体重指数每增加1个标准差，风险显著增加，相应的HR分别为1.89（1.6 - 2.23）和1.435（1.080 - 1.905）。在父母潜在危险因素中，父亲的T2D病史与青少年糖尿病前期/T2D风险增加独立相关（HR = 1.63(1.02 - 2.60)）。
每年约1%的伊朗青少年发展为糖尿病前期/T2D。在不可改变的危险因素中，父亲的T2D病史；在可改变的危险因素中，一般肥胖的存在以及较高的FPG水平，在青少年中应被视为成年早期发展为糖尿病前期/T2D的因素。
