Background: Latino youth are disproportionately impacted by type 2 diabetes (T2D). Prediabetes is an intermediate stage in the pathogenesis of T2D and represents a critical opportunity for prevention in adults. In youth and adults, prediabetes is identified by HbA1c, fasting glucose, and/or 2-hour glucose (2HrGluc). In youth, it is not well-characterized whether prediabetes by each criterion confers a similar metabolic profile. The objective of this study is to compare baseline characteristics of prediabetic Latino youth enrolled in a randomized, controlled diabetes prevention trial based on hyperglycemic status.
Methods: Participants were selected for the following inclusion criteria: 1) Latino ancestry, 2) Age 12-16 years, 3) BMI ≥ 95th percentile for age and sex, and 4) Prediabetes defined as HbA1c ≥ 5.7% and < 6.5%, fasting glucose ≥ 100 and < 126 mg/dL, or 2HrGluc ≥ 120 and < 200 mg/dL after an OGTT.
Results: Ninety-four youth (age 13.5±1.4 years, 59 male/35 female) met inclusion criteria with 25% eligible by HbA1c, 45% by 2HrGluc, and 30% based on more than one criterion. No participant met eligibility by fasting glucose alone. Those who met eligibility by more than one criterion were more likely to be exposed to gestational diabetes in utero (19.2%) compared to 2HrGluc (7.9%) or HbA1c (0%) groups, P=0.04. The multiple eligibility group also exhibited higher hepatic fat fraction by MRI (11.9%) compared to 2HrGluc (7.6%) and HbA1c (6.6%) groups, P=0.055. There were no statistically significant differences between eligibility groups in body fat percentage, BMI percentile, diabetes family history, liver enzymes, or lipid profiles.
Conclusion: These data suggest that obese Latino adolescents with prediabetes according to more than one criteria were more likely to be exposed to hyperglycemia in utero and exhibit higher liver fat content. Whether prediabetes criteria are associated with a differential response to lifestyle intervention will be tested in this clinical trial.
M. Olson: None. Y.P. Konopken: None. F.G. Castro: None. H.H. Hu: None. C. Keller: None. D.L. Patrick: None. A. Williams: None. S. Ayers: None. W.C. Knowler: None. J. Pimentel: None. A. Pena: None. E.G. Soltero: None. G.Q. Shaibi: None.
National Institutes of Health (R01DK107579P)