Postraduate Program in Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
National Institute of Science and Technology for Health Technology Assessment, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
Pediatr Diabetes. 2019 Jun;20(4):389-396. doi: 10.1111/pedi.12828. Epub 2019 Apr 2.
Type 2 diabetes mellitus (T2DM) in adolescents represents a clinical challenge related to lifestyle and obesity; however, only a few data are available in developing countries. Therefore, our aim was to investigate the prevalence of T2DM and prediabetes among Brazilian adolescents, as well as to describe the cardio-metabolic profile according to the diagnosis.
This is a cross-sectional school-based multicenter study including youth aged 12 to 17 years from cities with more than 100 000 inhabitants in Brazil (n = 37 854 students). Fasting glucose, hemoglobin A1c (HbA1c) and other cardio-metabolic risk factors were measured. Prediabetes was defined by glucose levels 100 to 125 mg/dL or HbA1c 5.7% to 6.4%. T2DM was defined by self-report, glucose ≥126 mg/dL or HbA1c ≥ 6.5%. Multinomial logistic regression was used to estimate the odds ratio (OR) of prediabetes or T2DM according to covariates.
Prevalences of prediabetes and T2DM were 22.0% (95% confidence interval [CI] 20.6%-23.4%) and 3.3% (95% CI 2.9%-3.7%), respectively. This estimates represented 213 830 adolescents living with T2DM and 1.46 million adolescents with prediabetes in Brazil. Prevalences of cardio-metabolic risk factors were higher in adolescents with prediabetes and T2DM. In the multinomial logistic model, obesity (OR 1.59, 95% CI 1.20-2.11), high waist circumference (OR 1.51, 95% CI 1.13-2.01), and skipping breakfast (OR 1.48, 95% CI 1.21-1.81) were associated with an increased OR for T2DM, while studying at rural area (OR 0.56, 95% CI 0.41-0.78) was associated with a decreased OR for T2DM.
The prevalence of T2DM and prediabetes was high among Brazilian adolescents, which highlights that this disease became a public health challenge not only among adults in Brazil.
青少年 2 型糖尿病（T2DM）与生活方式和肥胖有关，是一个临床挑战；然而，发展中国家仅有少量相关数据。因此，我们的目的是调查巴西青少年 T2DM 和糖尿病前期的患病率，并根据诊断描述其心血管代谢特征。
这是一项在巴西城市进行的基于学校的多中心横断面研究，纳入了年龄在 12 至 17 岁的青少年（n=37854 名学生）。测量空腹血糖、糖化血红蛋白（HbA1c）和其他心血管代谢危险因素。糖尿病前期定义为血糖水平 100 至 125mg/dL 或 HbA1c 5.7%至 6.4%。T2DM 通过自我报告、血糖≥126mg/dL 或 HbA1c≥6.5%来定义。使用多变量逻辑回归估计根据协变量预测糖尿病前期或 T2DM 的比值比（OR）。
糖尿病前期和 T2DM 的患病率分别为 22.0%（95%置信区间[CI] 20.6%-23.4%）和 3.3%（95%CI 2.9%-3.7%）。这估计代表了巴西 213830 名 T2DM 青少年和 146 万糖尿病前期青少年。糖尿病前期和 T2DM 青少年的心血管代谢危险因素患病率更高。在多变量逻辑模型中，肥胖（OR 1.59，95%CI 1.20-2.11）、高腰围（OR 1.51，95%CI 1.13-2.01）和不吃早餐（OR 1.48，95%CI 1.21-1.81）与 T2DM 的 OR 增加相关，而在农村地区学习（OR 0.56，95%CI 0.41-0.78）与 T2DM 的 OR 降低相关。
巴西青少年 T2DM 和糖尿病前期的患病率很高，这表明该疾病不仅在巴西成年人群中，而且在巴西青少年中也成为了一个公共卫生挑战。
