Background: There are limited data regarding modifiable lifestyle behaviors and prediabetes among US Asian/Pacific Islander (API) children. This study characterizes the association of obesogenic behaviors and weight with prediabetes among API adolescents with obesity receiving pediatric care.

Methods: We used retrospective data from 3,233 API adolescents aged 13-17 years in a US healthcare system who had well child visits in 2016-2019, provided well-check information on health behaviors, had BMI ≥95th percentile, and HbA1c level (within 1 year). Age, sex, self-reported daily obesogenic behaviors (eating <5 servings of fruits/vegetables, drinking ≥12 oz juice/soda, exercising for <60 minutes, >2 hours screen time), obesity level (Class I,2,3) and neighborhood deprivation index (NDI) were examined. Prediabetes was defined as HbA1c 5.7-6.4%; those with HbA1c ≥6.5% or diabetes diagnosis were excluded. Multivariable logistic regression was used to examine the association of these factors and prediabetes.

Results: Among 3,233 API adolescents (mean age 14.6 ± 1.4 y; 63.8% male) with obesity, 22.4% had prediabetes (84.4% had HbA1c 5.7-5.9%). Prediabetes did not differ by age or sex but increased with obesity level (20.1%, 25.2%, 33.2% for Class 1, 2, 3 obesity, respectively). In unadjusted analyses, low exercise was marginally associated with prediabetes (p=0.07) but not diet or screen time. In fully adjusted multivariable analyses, obesity severity (OR 1.98 [95% CI 1.47-2.64] for class 3, OR 1.34 [1.10-1.63] for class 2 vs 1), and low exercise (OR 1.20 [1.01-1.44]) were associated with increased odds of prediabetes, whereas other modifiable behaviors were not.

Conclusion: About 1 in 5 API adolescents with obesity had prediabetes, associated with obesity severity and low exercise. These findings support efforts that address obesity and promote physical activity in API children to reduce the risk of diabetes. Further studies should examine potential differences by ethnic group.

Disclosure

C.Chu: None. L.A.Rodriguez: None. M.Chandra: None. L.Greenspan: None. A.M.Bacong: None. J.C.Lo: None.

Funding

Kaiser Permanente Northern California

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