Diabetes Epidemiology and Clinical Research Section, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health, Phoenix, Arizona.
Division of Endocrinology and Diabetes, Phoenix Children's Hospital, Phoenix, Arizona.
Pediatr Diabetes. 2018 Jun;19(4):622-629. doi: 10.1111/pedi.12627. Epub 2017 Dec 28.
The risk of early-onset type 2 diabetes associated with the severity of obesity in youth is not well understood. This study aims to determine metabolic alterations and type 2 diabetes risk among American Indian children who are obese or severely obese.
Incidence rates of diabetes before 20 years (youth-onset) and 45 years were computed in 2728 children who were from 5 to <10 years and 4317 adolescents who were from 10 to <18 years without diabetes examined between 1965 and 2007. Obesity was defined as age-sex-adjusted body mass index (BMI) ≥95th percentile, and its severity was quantified as the percentage of the 95th percentile (%BMI ).
In the younger cohort, 0.9% of those non-obese and 2.9% of those with 100% to <120%BMI had impaired glucose tolerance (IGT) compared to 8.6% of those with ≥140%BMI . In the older cohort, 2.9% of those non-obese and 9.8% of those with 100% to <120%BMI had IGT compared to 13.3% of those with ≥160%BMI . The incidence of youth-onset diabetes was 3.8 and 4.9/1000 person-years in the child and adolescent cohorts, respectively, and before the age of 45 was 12.3 and 16.8/1000 person-years, respectively. Incidence rates of youth-onset diabetes in those with the most severe obesity (≥140%BMI ) were 2.3 to 5.1 times as high as in those with the least severe obesity (100 to <120%BMI ), and for onset of diabetes before the age of 45 were 1.6 to 2.2 times as high.
Severe obesity in an American Indian population is a major driver of type 2 diabetes developing in adolescents and young adults.
儿童肥胖程度与早发 2 型糖尿病风险之间的关系尚不清楚。本研究旨在确定美国印第安儿童中肥胖或重度肥胖者的代谢变化和 2 型糖尿病风险。
在 1965 年至 2007 年间接受检查、无糖尿病且年龄在 5 岁至<10 岁的 2728 名儿童和年龄在 10 岁至<18 岁的 4317 名青少年中，计算了 20 岁前（青少年发病）和 45 岁前的糖尿病发病率。肥胖定义为年龄性别调整后的体重指数（BMI）≥第 95 百分位数，其严重程度用第 95 百分位数（%BMI）的百分比量化。
在年龄较小的队列中，与非肥胖者相比，100%至<120%BMI 的者中有 0.9%糖耐量受损（IGT），而≥140%BMI 的者中有 8.6%；在年龄较大的队列中，与非肥胖者相比，100%至<120%BMI 的者中有 2.9%IGT，而≥160%BMI 的者中有 9.8%IGT。青少年发病的糖尿病发病率在儿童队列中为 3.8 和 4.9/1000 人年，在青少年队列中为 12.3 和 16.8/1000 人年，分别在 45 岁之前。最严重肥胖（≥140%BMI）者的青少年发病糖尿病发病率比最轻度肥胖（100%至<120%BMI）者高 2.3 至 5.1 倍，45 岁前发病糖尿病发病率高 1.6 至 2.2 倍。
在美洲印第安人群中，重度肥胖是导致青少年和年轻成年人发生 2 型糖尿病的主要因素。
