加载中........
×

Diabetes Care:青少年肥胖者发生糖尿病风险高于成人

2013-4-12 作者:Diabetes Care   来源:医脉通 我要评论0
Tags: 糖尿病  肥胖  

美国一项纵向队列研究结果显示,与成年型肥胖相比,青少年肥胖的个体发生糖尿病的风险更高,强调为预防糖尿病需努力解决儿童青少年肥胖问题。该论文发表于4月《糖尿病护理》(Diabetes Care)。

  目前尚无研究在基于人群的多种族样本中研究在青春期至青年期高风险期间肥胖发生和持续时间对糖尿病的影响。

  研究人员对10,481名年龄12-21岁参加美国国家青少年健康(1996年)纵向研究的患者队列在年轻成年期(18-27岁,2001-2002年;24-33岁,2007-2009年)进行2次随访。采用独立logistic回归模型研究糖尿病(A1C≥6.5%或已被确诊的患者)与年轻成年期随时间推移的肥胖发生(从来没有肥胖、<16岁发生、16~ <18岁发生、≥18岁发生)和肥胖持续时间(从未肥胖、偶尔肥胖、肥胖波动和持久性肥胖)的关联性,对不同性别和种族分别进行检验。

  结果显示,在24-33岁的受试者,4.4%有糖尿病(约一半未确诊),黑人和西班牙裔的患病率高于白人。在多变量分析中,即使校正了当前BMI、腰围和月经初潮年龄,16岁之前就发生肥胖的女性与18岁或之后发生肥胖的女性相比,其发生糖尿病的可能性更大(比值比为2.77 [95%CI 1.39-5.52])。持续(相对于成年后肥胖)肥胖增加男性(2.27 [1.41-3.64])和女性的糖尿病发病可能性(2.08 [1.34-3.24])。

Timing and Duration of Obesity in Relation to Diabetes: Findings from an ethnically diverse, nationally representative sample.
OBJECTIVE
The influence on diabetes of the timing and duration of obesity across the high-risk period of adolescence to young adulthood has not been investigated in a population-based, ethnically diverse sample.
RESEARCH DESIGN AND METHODS
A cohort of 10,481 individuals aged 12-21 years enrolled in the U.S. National Longitudinal Study of Adolescent Health (1996) was followed over two visits during young adulthood (18-27 years, 2001-2002; 24-33 years, 2007-2009). Separate logistic regression models were used to examine the associations of diabetes (A1C ≥6.5% or diagnosis by a health care provider) in young adulthood with 1) obesity timing (never obese, onset <16 years, onset 16 to <18 years, onset ≥18 years) and 2) obesity duration over time (never obese, incident obesity, fluctuating obesity, and persistent obesity), testing differences by sex and race/ethnicity.
RESULTS
Among 24- to 33-year-old participants, 4.4% had diabetes (approximately half were undiagnosed), with a higher prevalence in blacks and Hispanics than whites. In multivariable analyses, women who became obese before age 16 were more likely to have diabetes than women who became obese at or after age 18 (odds ratio 2.77 [95% CI 1.39-5.52]), even after accounting for current BMI, waist circumference, and age at menarche. Persistent (vs. adult onset) obesity was associated with increased likelihood of diabetes in men (2.27 [1.41-3.64]) and women (2.08 [1.34-3.24]).
CONCLUSIONS
Diabetes risk is particularly high in individuals who were obese as adolescents relative to those with adult-onset obesity, thus highlighting the need for diabetes prevention efforts to address pediatric obesity.



小提示:78%用户已下载梅斯医学APP,更方便阅读和交流,请扫描二维码直接下载APP

所属期刊:DIABETES CARE 期刊论坛:进入期刊论坛

只有APP中用户,且经认证才能发表评论!马上下载

web对话