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Examining trends in prediabetes and its relationship with the metabolic syndrome in US adolescents, 1999–2014

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Abstract

Aims

We sought to investigate temporal trends in prediabetes prevalence among US adolescents using two definitions and evaluate relationships with obesity and a MetS-severity score.

Methods

We evaluated data from 5418 non-Hispanic white, non-Hispanic black, and Hispanic adolescents aged 12–19 participating in the National Health and Nutrition Examination Survey 1999–2014 with complete data regarding MetS and hemoglobin A1c (HbA1c). Prediabetes status was defined by American Diabetes Association (ADA) criteria: fasting glucose 100–125 mg/dL or HbA1c 5.7%–6.4%. MetS severity was assessed with a MetS-severity Z-score.

Results

Prevalence of prediabetes as defined by HbA1c abnormalities significantly increased from 1999–2014, while prevalence of prediabetes as defined by fasting glucose abnormalities showed no significant temporal trend. There were variations in these trends across different racial/ethnic groups. MetS Z-score was overall more strongly correlated with HbA1c, fasting insulin, and the homeostasis model of insulin resistance than was BMI Z-score. These correlations were true in each racial/ethnic group with the exception that in non-Hispanic white adolescents, in whom the MetS Z-score was not significantly correlated with HbA1c measurements.

Conclusion

We found conflicting findings of temporal trends of US adolescent prediabetes prevalence based on the ADA’s prediabetes criteria. The increasing prevalence of prediabetes by HbA1c assessment is concerning and raises the urgency for increased awareness and appropriate measures of prediabetes status among physicians and patients.

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Funding

This work was supported by National Institutes of Health grant 1R01HL120960 (MJG and MDD).

Author information

Authors and Affiliations

  1. Department of Pediatrics, University of Virginia, Charlottesville, VA, 22908, USA

    Arthur M. Lee, Cyrelle R. Fermin & Mark D. DeBoer

  2. Department of Health Outcomes and Policy, College of Medicine, University of Florida, Gainesville, FL, 32608, USA

    Stephanie L. Filipp & Matthew J. Gurka

Authors
  1. Arthur M. Lee
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  2. Cyrelle R. Fermin
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  3. Stephanie L. Filipp
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  4. Matthew J. Gurka
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  5. Mark D. DeBoer
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Corresponding author

Correspondence to Mark D. DeBoer.

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Ethical standard

This study was approved by the ethics review board of the National Center for Health Statistics, and all participants provided their informed consent in writing.

Human and animal rights

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975.

Informed consent

Informed consent was obtained from all patients for being included in the study.

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Managed by Massimo Federici.

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Lee, A.M., Fermin, C.R., Filipp, S.L. et al. Examining trends in prediabetes and its relationship with the metabolic syndrome in US adolescents, 1999–2014. Acta Diabetol 54, 373–381 (2017). https://doi.org/10.1007/s00592-016-0958-6

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  • DOI: https://doi.org/10.1007/s00592-016-0958-6

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