Saeed Walid, Al-Habori Molham, Saif-Ali Riyadh, Al-Eryani Ekram
Department of Biochemistry and Molecular Biology, Faculty of Medicine and Health Sciences, University of Sana`a, Sana`a, Yemen.
Diabetes Metab Syndr Obes. 2020 Jul 20;13:2563-2572. doi: 10.2147/DMSO.S260131. eCollection 2020.
In view of the high rate of obesity and physical inactivity as well as the rising incidence of Type 2 DM among children in the neighboring Gulf countries and Middle East region; the aim of this study was, therefore, to determine the prevalence of metabolic syndrome (MetS) and prediabetes in Yemeni school-aged children.
In this study, 1402 school children aged 12-13 years old (grade 7) were recruited from public schools in the capital Sana'a during the period April-May 2013. Anthropometric measurements and BP were recorded and BMI was calculated. Fasting venous blood (5 mL) was collected for biochemical analysis including FBG, HbA1c, insulin and lipids profile. Insulin resistance (HOMA-IR) and β-cell function (HOMA-β) were calculated.
The prevalence of prediabetes (as defined by impaired fasting glucose) and MetS (as classified by the IDF 2007) were 0.86% and 0.5%, respectively. Our results also showed 5.21% and 20.26% of the children to have two or one factor(s) of the MetS criteria fulfilled, respectively, with low HDL-c (17%) being the most prevalent MetS component, followed by metabolic glucose (8%), raised TG (5.3%), DBP (1.4%), and high WC (0.5%). Moreover, the prevalence of overweight and obesity was 4.2% and 2.8%, respectively; and about 1.2% of children had abnormal high insulin levels. Children with impaired fasting glucose (IFG) had increased HOMA-IR (p = 0.016) and SBP (p = 0.042) and decreased HDL-c (p = 0.034) and HOMA-β (p < 0.001); whereas obese children had increased WC (p < 0.001) and TG (p = 0.049).
The main finding of this study is that Yemeni children are at potential risk of obesity, metabolic syndrome and prediabetes despite their low prevalences. These results highlight the need for early identification and close monitoring of children at risk of later Type 2 DM as an important primary care strategy that can effectively prevent or delay the onset of such condition.
鉴于邻国海湾国家和中东地区儿童肥胖率高、身体活动不足以及2型糖尿病发病率不断上升;因此,本研究的目的是确定也门学龄儿童代谢综合征(MetS)和糖尿病前期的患病率。
本研究于2013年4月至5月期间,从首都萨那的公立学校招募了1402名12 - 13岁(七年级)的学童。记录人体测量数据和血压,并计算BMI。采集空腹静脉血(5 mL)进行生化分析,包括空腹血糖(FBG)、糖化血红蛋白(HbA1c)、胰岛素和血脂谱。计算胰岛素抵抗(HOMA - IR)和β细胞功能(HOMA - β)。
糖尿病前期(以空腹血糖受损定义)和MetS(按照2007年国际糖尿病联盟分类)的患病率分别为0.86%和0.5%。我们的结果还显示,分别有5.21%和20.26%的儿童满足MetS标准的两个或一个因素,其中低高密度脂蛋白胆固醇(HDL - c,17%)是最常见的MetS组分,其次是代谢性血糖(8%)、甘油三酯升高(5.3%)、舒张压(DBP,1.4%)和高腰围(WC,0.5%)。此外,超重和肥胖患病率分别为4.2%和2.8%;约1.2%的儿童胰岛素水平异常升高。空腹血糖受损(IFG)的儿童HOMA - IR升高(p = 0.016)、收缩压(SBP,p = 0.042)升高、HDL - c降低(p = 0.034)以及HOMA - β降低(p < 0.001);而肥胖儿童WC升高(p < 0.001)和甘油三酯升高(p = 0.049)。
本研究的主要发现是,也门儿童尽管患病率较低,但仍面临肥胖、代谢综合征和糖尿病前期的潜在风险。这些结果凸显了早期识别和密切监测有患2型糖尿病风险儿童的必要性,这是一项重要的初级保健策略,可有效预防或延缓此类疾病的发生。