Several office-based pediatric measures, including body mass index and systolic and diastolic blood pressure, were significant predictors of type 2 diabetes in adulthood, based on data from a pair of follow-up studies including nearly 2,000 school-aged children.
The ability to identify children who are on the path to adult type 2 diabetes may give physicians an opportunity to intervene with diet and exercise recommendations, said John A. Morrison, Ph.D., of Cincinnati Children's Hospital Medical Center.
Dr. Morrison and his colleagues reviewed data from two prospective studies. The National Growth and Health Study (NGHS) included 1,067 girls with a mean age of 10 years who were reassessed at a mean age of 19 years. The NGHS measured body mass index (BMI); systolic and diastolic blood pressure; waist circumference; HDL cholesterol, fasting insulin, glucose, and lipid profiles; and parental diabetes.
The second study, the Princeton Follow-Up Study (PFS), included 822 boys and girls 6–18 years (mean age, 12 years) who were reassessed at a mean age of 39 years. The PFS measured BMI, systolic and diastolic blood pressure, parental diabetes, triglycerides, HDL cholesterol, and fasting glucose.
The final analysis included data from 80% of the girls in the NGHS and 53% of the children in the PFS (Arch. Pediatr. Adolesc. Med. 2010;164:53–60).
After cases of diabetes were excluded at study entry, the incidence of diabetes at age 39 years in the PFS was 5%. The incidence was higher in black women than white women (10% vs. 4%) and higher in black men than white men (5% vs. 3%). In the NGHS, diabetes incidence after 9 years was 1.2% in black women and 0.2% in white women.
In the PFS, childhood systolic blood pressure, BMI in the top fifth percentile, and black race were significant predictors of type 2 diabetes at 39 years of age. Conversely, if childhood BMI, systolic blood pressure, and diastolic blood pressure all fell below the 75th percentile, the chance of type 2 diabetes at 39 years of age was 2% if the parents had diabetes and 1% if they did not.
In the PFS, “simple office and laboratory measurements and knowledge of parental diabetes usefully predicted” the development of type 2 diabetes 22–30 years later, the researchers wrote.
In the NGHS, childhood systolic blood pressure in the top fifth percentile and parental diabetes were significant predictors of type 2 diabetes at age 19 years. If childhood BMI, systolic blood pressure, and diastolic blood pressure all fell below the 75th percentile, the chance of type 2 diabetes at 19 years of age was 0.2% whether the parents had diabetes or not, and 0.3% if childhood insulin also was below the 75th percentile.
Disclosures: The researchers had no financial conflicts to disclose. The study was supported in part by grants from the National Institutes of Health, the American Heart Association, the Taft Research Fund, and the Lipoprotein Research Fund of the Jewish Hospital of Cincinnati.
The ability to identify children on the path to type 2 diabetes may provide an opportunity to intervene.
Source DR. MORRISON