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Clinical characteristics and beta-cell function of Chinese children and adolescents with type 2 diabetes from 2009 to 2018

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Abstract

Background

The limited available studies have unveiled different natural histories and prognosis associated with pediatric type 2 diabetes (T2D) and adult T2D. To date, data on the clinical features, metabolic profiles and beta-cell function characteristics are still limited in the Chinese pediatric T2D population.

Methods

A total of 56 children with T2D, 31 with prediabetes and 159 with obesity were recruited. Clinical characteristics, metabolic profiles, beta-cell function and insulin resistance were analyzed.

Results

The mean onset age of T2D was 12.35 ± 1.99 (7.9–17.8) years, and 7% of children were younger than 10 years; 55% of them were male, 57% had a family history of diabetes and 64% had classic symptoms, and 25% had a low or high birth weight. 89% of T2D patients were obese or overweight. A total of 58% of the patients with prediabetes were male. The fast serum C-peptide level was highest in the obesity group (P < 0.001), and there was no significant difference between the T2D and prediabetes groups. The mean homeostatic model of assessment of beta-cell function was the highest in the obesity group and was lowest in the T2D group (P < 0.001). The T2D group had the most serious lipid metabolism disorder, with the highest levels of total triglycerides, total cholesterol, and low density lipoprotein and the lowest high density lipoprotein level among the three groups.

Conclusions

A younger onset age and greater male susceptibility were found in Chinese pediatric T2D patients, and there was a stepwise deterioration trend in beta-cell function among patients with obesity, prediabetes and T2D. Based on our results, together with the SEARCH study results, an early screening and intervention program for T2D is recommended in high-risk or obese Chinese pediatric populations starting at 7 years.

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Acknowledgements

We would like to thank the parents and children for participating in the study. We thank the doctors and nursing staff of our center for their detailed assessments and dedicated care of these young patients. This project was funded by the National Key Research and Development Program of China (2016YFC1305302).

Funding

This project was funded by the National Key Research and Development Program of China (2016YFC1305302).

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Authors and Affiliations

  1. Department of Pediatric Endocrinology and Inherited Metabolic Diseases, Children’s Hospital of Fudan University, 399 Wan Yuan Road, Shanghai, 201102, China

    Zhen-Ran Xu, Miao-Ying Zhang, Jin-Wen Ni, Ruo-Qian Cheng, Zhang-Qian Zheng, Li Xi & Fei-Hong Luo

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  1. Zhen-Ran Xu
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  2. Miao-Ying Zhang
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Contributions

ZRX collected and analyzed data, and drafted the manuscript. FHL designed the project and revised the manuscript. All other authors helped in the clinical management of the patients, and have read and approved the final manuscript.

Corresponding author

Correspondence to Fei-Hong Luo.

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Ethic permission was approved from the Ethic Commission of Children’s Hospital of Fudan University.

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All the authors have no conflicts of interest.

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Xu, ZR., Zhang, MY., Ni, JW. et al. Clinical characteristics and beta-cell function of Chinese children and adolescents with type 2 diabetes from 2009 to 2018. World J Pediatr 15, 405–411 (2019). https://doi.org/10.1007/s12519-019-00243-5

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