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OBJECTIVE - Impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT) are considered to constitute "pre-diabetes." We estimated the prevalence of IFG, IGT, and pre-diabetes among U.S. adolescents using data from a nationally representative sample.
RESEARCH DESIGN AND METHODS - We analyzed data from participants aged 12-19 years in the National Health and Nutrition Examination Survey 2005-2006. We used fasting plasma glucose and 2-h glucose during an oral glucose tolerance test to assess the prevalence of IFG, IGT, and pre-diabetes and used the log-binomial model to estimate the prevalence ratios (PRs) and 95% CIs.
RESULTS - The unadjusted prevalences of IFG, IGT, and pre-diabetes were 13.1, 3.4, and 16.1%, respectively. Boys had a 2.4-fold higher prevalence of pre-diabetes than girls (95% CI 1.3-4.3). Non-Hispanic blacks had a lower rate than non-Hispanic whites (PR 0.6, 95% CI 0.4-0.9). Adolescents aged 16-19 years had a lower rate than those aged 12-15 years (0.6, 0.4-0.9). Overweight adolescents had a 2.6-fold higher rate than those with normal weight (1.3-5.1). Adolescents with two or more cardiometabolic risk factors had a 2.7-fold higher rate than those with none (1.5-4.8). Adolescents with hyperinsulinemia had a fourfold higher prevalence (2.2-7.4) than those without. Neither overweight nor number of cardiometabolic risk factors was significantly associated with pre-diabetes after adjustment for hyperinsulinemia.
CONCLUSIONS - Pre-diabetes was highly prevalent among adolescents. Hyperinsulinemia was independently associated with pre-diabetes and may account for the association of overweight and clustering of cardiometabolic risk factors with pre-diabetes.
Diabetes Care 32:342-347, 2009
Individuals with impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT) are at increased risk for diabetes and cardiovascular-related death (1,2). The state of abnormal glucose metabolism characterized as IFG and/or IGT has been referred to as "pre-diabetes" (3).
Previous studies of IGT among children and adolescents have been largely limited to those with obesity, a family his- tory of diabetes, or multiple cardiometa- bolic risk factors. The prevalence estimates of IGT varied from 4 to 21% in previous studies (4-7). Although IGT prevalence estimates among overweight adolescents is helpful in understanding the absolute health risk associated with IGT in this special population, the relative health burden of IGT among overweight adolescents compared with that among adolescents of normal weight has not been established. In a few school...