Department of Nutritional Sciences, College of Natural Sciences, University of Texas at Austin, Austin, TX, USA.
New York University, Grossman School of Medicine, Department of Medicine, New York, USA.
Nutr Diabetes. 2023 Sep 9;13(1):15. doi: 10.1038/s41387-023-00244-4.
BACKGROUND/OBJECTIVES: Obesity and other predictors of type 2 diabetes disproportionally affect Hispanic and Black children in the US compared to non-Hispanic White (NHW) children. Yet, the prevalence of prediabetes in children remains unestablished, and guidelines for screening young children are lacking. This study examined the relationships between demographic factors and prediabetes in vulnerable youth in central Texas.
SUBJECTS/METHODS: This is a cross-sectional analysis of baseline data from 976 3rd-5th graders (7-12 years) who participated in TX Sprouts, a school-based gardening, nutrition, and cooking trial in 16 elementary schools serving mainly children from minority backgrounds and lower-income households. Measures collected included age, sex, ethnicity, free/reduced-priced school lunch (FRL) status, parent educational attainment (questionnaires), BMI from height (stadiometer) and weight (TANITA scale), and prediabetes status from fasting plasma glucose (FPG) and HbA1c. Regressions examined cross-sectional associations between demographics and FPG, HbA1c, and prediabetes.
Children were 47% male, 67% Hispanic, and 10% Black, with a mean age of 9.3 years; 71% received FRL, 50% had overweight/obesity, and 26% had prediabetes. Prediabetes rates were 2.8 and 4.8 times higher in Hispanic and Black children compared to NHW children, respectively (p ≤ 0.001), and 1.5 times higher in children with obesity versus normal BMI (p = 0.02). Children of parents with only an 8th-grade education, some high school education, or a high school degree had 3.1, 2.7, and 2.2 times higher odds of having prediabetes compared to children of college graduates, respectively (p ≤ 0.004). Analyses with FPG and HbA1c yielded similar results.
These findings suggest a potential need for earlier screening, more comprehensive testing guidelines, and prevention programs tailored toward minority children, children with obesity, and children of parents with low educational attainment. Future research should explore this finding in a larger, nationally representative sample.
背景/目的：与非西班牙裔白人（NHW）儿童相比，肥胖和其他 2 型糖尿病预测因素在美国不成比例地影响西班牙裔和非裔儿童。然而，儿童中糖尿病前期的患病率仍未确定，且缺乏针对幼儿的筛查指南。本研究旨在研究中德克萨斯州弱势青少年中人口统计学因素与糖尿病前期之间的关系。
受试者/方法：这是一项对参与 TX Sprouts 的 976 名 3-5 年级（7-12 岁）学生的基线数据的横断面分析。TX Sprouts 是一项在 16 所小学开展的基于学校的园艺、营养和烹饪试验，主要为少数民族背景和低收入家庭的儿童服务。收集的测量指标包括年龄、性别、种族、免费/减价学校午餐（FRL）状况、父母教育程度（问卷）、身高（身高计）和体重（TANITA 秤）的 BMI 以及空腹血糖（FPG）和糖化血红蛋白（HbA1c）的糖尿病前期状态。回归分析了人口统计学因素与 FPG、HbA1c 和糖尿病前期之间的横断面关联。
儿童中 47%为男性，67%为西班牙裔，10%为非裔，平均年龄为 9.3 岁；71%的儿童接受 FRL，50%的儿童超重/肥胖，26%的儿童患有糖尿病前期。与 NHW 儿童相比，西班牙裔和非裔儿童的糖尿病前期发生率分别高 2.8 倍和 4.8 倍（p≤0.001），而肥胖儿童的糖尿病前期发生率比正常 BMI 儿童高 1.5 倍（p=0.02）。仅接受过 8 年级教育、一些高中教育或高中学历的儿童与大学毕业生相比，患有糖尿病前期的可能性分别高出 3.1 倍、2.7 倍和 2.2 倍（p≤0.004）。使用 FPG 和 HbA1c 进行的分析得出了类似的结果。
这些发现表明，可能需要针对少数民族儿童、肥胖儿童和低学历父母的子女，更早地进行筛查、更全面的检测指南和预防计划。未来的研究应在更大的、具有全国代表性的样本中探索这一发现。
