TY - JOUR
T1 - Strategy for early identification of prediabetes in lean populations
T2 - New insight from a prospective Chinese twin cohort of children and young adults
AU - Wang, Guoying
AU - Radovick, Sally
AU - Xu, Xiping
AU - Xing, Houxun
AU - Tang, Genfu
AU - Bartell, Tami R.
AU - Wang, Binyan
AU - Wang, Xiaobin
N1 - Funding Information:
This work was supported in part by National Institutes of Health grants R01HD049059 , R01HL086461 , and R01AG032227 .
Publisher Copyright:
© 2018 Elsevier B.V.
PY - 2018/12
Y1 - 2018/12
N2 - Aims: To identify certain subgroups in young and lean populations, who may be at a high risk of developing prediabetes/diabetes, which is not captured by current BMI-based screening algorithms. Methods: Incidence of prediabetes/diabetes was assessed using oral glucose tolerance tests among 1859 children and 1073 young adults from a prospective Chinese twin cohort. Results: Over a 6-year follow-up, 507 (27.3%) children and 293 (27.3%) adults developed prediabetes/diabetes. Of the 800 incidents, 737(92.1%) and 644(80.5%) were lean at baseline and follow-up, respectively. Baseline fasting glucose in the top tertile of the normal range was associated with an increased risk of prediabetes/diabetes: odds ratio, 1.85 (95% CI 1.32–2.59) and 3.29 (95%CI 2.10–5.17) among normal weight and underweight children, respectively, and 2.74 (95% CI 1.78–4.23) and 3.08 (95% CI 1.69–5.58) among normal weight and overweight/obese adults, respectively, compared with the low tertile of fasting glucose. Conclusions: We showed that majority incident cases of prediabetes/diabetes were not overweight/obese (at baseline), who would have been missed by traditional screening algorithm emphasizing overweight/obesity. Our findings revealed that an upper end of normal fasting glucose was a simple and robust predictor of future higher risk of prediabetes/diabetes in this young and lean population.
AB - Aims: To identify certain subgroups in young and lean populations, who may be at a high risk of developing prediabetes/diabetes, which is not captured by current BMI-based screening algorithms. Methods: Incidence of prediabetes/diabetes was assessed using oral glucose tolerance tests among 1859 children and 1073 young adults from a prospective Chinese twin cohort. Results: Over a 6-year follow-up, 507 (27.3%) children and 293 (27.3%) adults developed prediabetes/diabetes. Of the 800 incidents, 737(92.1%) and 644(80.5%) were lean at baseline and follow-up, respectively. Baseline fasting glucose in the top tertile of the normal range was associated with an increased risk of prediabetes/diabetes: odds ratio, 1.85 (95% CI 1.32–2.59) and 3.29 (95%CI 2.10–5.17) among normal weight and underweight children, respectively, and 2.74 (95% CI 1.78–4.23) and 3.08 (95% CI 1.69–5.58) among normal weight and overweight/obese adults, respectively, compared with the low tertile of fasting glucose. Conclusions: We showed that majority incident cases of prediabetes/diabetes were not overweight/obese (at baseline), who would have been missed by traditional screening algorithm emphasizing overweight/obesity. Our findings revealed that an upper end of normal fasting glucose was a simple and robust predictor of future higher risk of prediabetes/diabetes in this young and lean population.
KW - Fasting plasma glucose
KW - Incidence
KW - Prediabetes
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U2 - 10.1016/j.diabres.2018.10.003
DO - 10.1016/j.diabres.2018.10.003
M3 - Article
C2 - 30312713
AN - SCOPUS:85055112779
SN - 0168-8227
VL - 146
SP - 101
EP - 110
JO - Diabetes Research and Clinical Practice
JF - Diabetes Research and Clinical Practice
ER -