Division of Endocrinology, Department of Pediatrics, Saban Research Institute, Children's Hospital Los Angeles, Los Angeles, CA.
Department of Pediatrics, Keck School of Medicine, Los Angeles, CA.
Diabetes. 2023 Jun 1;72(6):735-745. doi: 10.2337/db22-1034.
Youth-onset type 2 diabetes (T2D) is becoming increasingly prevalent, especially among Latino youth, and there is limited information on its pathophysiology and causative factors. Here, we describe findings from a longitudinal cohort study in 262 Latino children with overweight/obesity at risk of developing T2D with annual measures of oral and intravenous glucose tolerance (IVGTT), body composition, and fat distribution. Logistic binomial regression was used to identify significant predictors in those who developed T2D compared with matched control participants, and mixed-effects growth models were used to compare rates of change in metabolic versus adiposity measures between groups. Overall conversion rate to T2D at year 5 was 2% (n = 6). Rate of decline in disposition index (DI), measured with an IVGTT, over 5 years was three times higher in case patients (-341.7 units per year) compared with the extended cohort (-106.7 units per year) and 20 times higher compared with control participants (-15.2 units per year). Case patients had significantly higher annual increases in fasting glucose, hemoglobin A1c (HbA1c), waist circumference, and trunk fat, and there was an inverse correlation between rate of decline in DI and rates of increase in adiposity measures. T2D development in at-risk Latino youth is associated with a substantial and rapid decrease in DI that is directly correlated with increases in fasting glucose, HbA1c, and adiposity.
Youth-onset type 2 diabetes is becoming increasingly prevalent, especially among Latino youth, and there is limited information on its pathophysiology and causative factors. Overall conversion rate to type 2 diabetes over 5 years was 2%. In youth who converted to type 2 diabetes, disposition index decreased rapidly by 85% compared with that in patients who did not convert during the study period. There was an inverse correlation between rate of decline in disposition index and rates of increase in various adiposity measures.
描述一项在 262 名超重/肥胖、有发展为 2 型糖尿病（T2D）风险的拉丁裔儿童中进行的纵向队列研究的结果。方法：对这些儿童进行了每年一次的口服和静脉葡萄糖耐量（IVGTT）、身体成分和脂肪分布测量。采用逻辑二项式回归来确定在发生 T2D 的患者与匹配的对照参与者相比，哪些因素具有统计学意义，采用混合效应增长模型来比较两组间代谢与肥胖指标的变化率。结果：5 年内 T2D 的总体转化率为 2%（n=6）。5 年内通过 IVGTT 测量的处置指数（DI）下降率在病例组患者中（每年-341.7 单位）是扩展队列（每年-106.7 单位）的 3 倍，是对照组（每年-15.2 单位）的 20 倍。病例组患者空腹血糖、糖化血红蛋白（HbA1c）、腰围和躯干脂肪的年增长率显著增加，DI 下降率与肥胖指标的增长率呈负相关。结论：在有发展为 T2D 风险的拉丁裔青年中，T2D 的发生与 DI 的显著且快速下降有关，而 DI 的下降与空腹血糖、HbA1c 和肥胖的增加直接相关。
