Highlights
- •Obese increase the prevalence of T2D and prediabetes in children and adolescents.
- •The prevalence of T2D in obese children and adolescents was 13 times that in normal weight subjects.
- •The prevalence of prediabetes in obese subjects was 3 times that in normal subjects.
- •The values of insulin, HbA1c and HOMA-IR were greater in obese subjects than in normal weight subjects.
Abstract
Aim
To assess the impact of the obesity epidemic on type 2 diabetes (T2D), prediabetes
and glycometabolic indices in children and adolescents.
Methods
We searched four electronic databases (PubMed, Embase, Cochrane and Web of Science).
Cross-sectional or cohort studies that reported on obesity and the prevalence of T2D
or prediabetes in children and adolescents were reviewed. The study design, sample
size and clinical outcomes were extracted from each study. The prevalence of T2D and
prediabetes from the studies were pooled using meta-analysis methods.
Results
Meta-analysis of 228184 participants showed that the prevalence of T2D was 1.3% (95%
confidence interval (CI), 0.6–2.1%) in obese subjects, which was 13 times that in
normal weight subjects (0.1%, 95% CI, 0.01–0.2%). The prevalence of prediabetes in
obese subjects was 3 times that in normal subjects at 17.0% (13.0−22.0%) vs. 6.0%
(0.01−11.0%). Moreover, BMI was positively correlated with the prevalence of T2D,
prediabetes and glycometabolic indices in obese children and adolescents.
Conclusion
The pooled results confirm that obesity in children and adolescents leads to statistically
significant increases in the prevalence of T2D and prediabetes and in glycometabolic
indicator levels.
Keywords
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References
- Adolescent BMI and early-onset type 2 diabetes among Ethiopian immigrants and their descendants: a nationwide study.Cardiovasc. Diabetol. 2020; 19: 168
- Prevalence of diabetes and prediabetes among children aged 11-14 years old in Vietnam.J. Diabetes Res. 2020; 20207573491
- Timing and duration of obesity in relation to diabetes: findings from an ethnically diverse, nationally representative sample.Diabetes Care. 2013; 36: 865-872
- Impaired glucose tolerance in obese white children and adolescents: three to five year follow-up in untreated patients.Exp. Clin. Endocrinol. Diabetes. 2011; 119: 172-176
- Type 2 diabetes mellitus and impaired glucose regulation in overweight and obese children and adolescents living in Serbia.Int. J. Obes. 2012; 36: 1479-1481
- Longitudinal multicenter analysis on the course of glucose metabolism in obese children.Int. J. Obes. 2013; 37: 931-936
- Cardiometabolic profile of obese children in a sub-Saharan African setting: a cross-sectional study.BMC Pedia. 2017; 17: 129
- Prevalence of type 2 diabetes and pre-diabetes among overweight or obese children in Tianjin, China.Diabet. Med. 2013; 30: 1457-1465
- Overweight and obesity among Vietnamese school-aged children: national prevalence estimates based on the World Health Organization and international obesity task force definition.PLoS One. 2020; 15e0240459
- Prevalence of overweight and obesity in hungarian children and adolescents.Ann. Nutr. Metab. 2018; 72: 259-264
- Trends in prevalence of thinness, overweight and obesity among Swedish children and adolescents between 2004 and 2015.Acta Paediatr. 2018; 107: 1818-1825
- HbA1c and glucose intolerance in obese children and adolescents.Diabet. Med. 2012; 29: e102-e105
- Diabetes screening in overweight and obese children and adolescents: choosing the right test.Eur. J. Pedia. 2017; 176: 89-97
- Laparoscopic sleeve gastrectomy in severely obese adolescents: effects on metabolic profile.Arch. Endocrinol. Metab. 2017; 61: 608-613
- The prognosis for glycemic status among children and youth with obesity 2 years after entering a weight management program.Pedia Diabetes. 2018; 19: 874-881
- Lack of agreement between the revised criteria of impaired fasting glucose and impaired glucose tolerance in children with excess body weight.Diabetes Care. 2004; 27: 2229-2233
- Oral glucose tolerance test in Italian overweight/obese children and adolescents results in a very high prevalence of impaired fasting glycaemia, but not of diabetes.Diabetes Metab. Res. Rev. 2009; 25: 528-534
- Changes in BMI, duration of overweight and obesity, and glucose metabolism: 45 years of follow-up of a birth cohort.Diabetes Care. 2011; 34: 1986-1991
- Genome analyses of >200,000 individuals identify 58 loci for chronic inflammation and highlight pathways that link inflammation and complex disorders.Am. J. Hum. Genet. 2018; 103: 691-706
- Prevalence of insulin resistance and impaired glucose tolerance in a sample of obese Spanish children and adolescents.Endocrine. 2012; 41: 289-295
- Islet function in obese adolescents.Diabetes Obes. Metab. 2012; 14: 40-45
- Childhood obesity and type 2 diabetes mellitus.Pediatrics. 2005; 116: 473-480
- Obesity and risk of type 2 diabetes and cardiovascular disease in children and adolescents.J. Clin. Endocrinol. Metab. 2003; 88: 1417-1427
- Session 7: early nutrition and later health early developmental pathways of obesity and diabetes risk.Proc. Nutr. Soc. 2007; 66: 451-457
- Methodological guidance for systematic reviews of observational epidemiological studies reporting prevalence and cumulative incidence data.Int. J. Evid. Based Health. 2015; 13: 147-153
- A basic introduction to fixed-effect and random-effects models for meta-analysis.Res. Synth. Methods. 2010; 1: 97-111
- Effect of mobile phone intervention for diabetes on glycaemic control: a meta-analysis.Diabet. Med. 2011; 28: 455-463
- Some general points in estimating heterogeneity variance with the DerSimonian-Laird estimator.Biostatistics. 2002; 3: 445-457
- Quantifying heterogeneity in a meta-analysis.Stat. Med. 2002; 21: 1539-1558
- Bias in meta-analysis detected by a simple, graphical test.Bmj. 1997; 315: 629-634
- Interaction between fatness and fitness on CVD risk factors in Asian youth.Int. J. Sport. Med. 2009; 30: 733-740
- Increased arterial stiffness is found in adolescents with obesity or obesity-related type 2 diabetes mellitus.J. Hypertens. 2010; 28: 1692-1698
- Youth with obesity and obesity-related type 2 diabetes mellitus demonstrate abnormalities in carotid structure and function.Circulation. 2009; 119: 2913-2919
- Increasing burden of type 2 diabetes in Navajo youth: the SEARCH for diabetes in youth study.Pedia Diabetes. 2019; 20: 815-820
- Exercise dose and diabetes risk in overweight and obese children: a randomized controlled trial.JAMA. 2012; 308: 1103-1112
- One-hour post-load plasma glucose predicts progression to prediabetes in a multi-ethnic cohort of obese youths.Diabetes Obes. Metab. 2019; 21: 1191-1198
- One-hour post-load plasma glucose levels associated with decreased insulin sensitivity and secretion and early makers of cardiometabolic risk.J. Endocrinol. Investig. 2017; 40: 771-778
- Persistence of pre-diabetes in overweight and obese Hispanic children: association with progressive insulin resistance, poor beta-cell function, and increasing visceral fat.Diabetes. 2008; 57: 3007-3012
- Progression from impaired glucose tolerance to type 2 diabetes in obese children and adolescents: a 3-6-year cohort study in southern Thailand.J. Pedia Endocrinol. Metab. 2016; 29: 1267-1275
- Glucose tolerance status in 510 children and adolescents attending an obesity clinic in Central Italy.Pedia Diabetes. 2010; 11: 47-54
- Prevalence of prediabetes among adolescents and young adults in the United States, 2005-2016.JAMA Pedia. 2020; 174e194498
- High prevalence of prediabetes in a Swedish cohort of severely obese children.Pedia Diabetes. 2015; 16: 117-128
- Elevated C-reactive protein in Native Canadian children: an ominous early complication of childhood obesity.Diabetes Obes. Metab. 2006; 8: 483-491
- Obesity and type 2 diabetes mellitus: a population-based study of adolescents.J. Pedia Endocrinol. Metab. 2004; 17: 1633-1640
- HbA1c and blood pressure measurements: relation with gender, body mass index, study field, and lifestyle in lebanese students.Endocr. Pr. 2019; 25: 1101-1108
- Identifying obesity indicators which best correlate with type 2 diabetes in a Chinese population.BMC Public Health. 2012; 12: 732
- Adipose tissue insulin resistance in youth on the spectrum from normal weight to obese and from normal glucose tolerance to impaired glucose tolerance to type 2 diabetes.Diabetes Care. 2019; 42: 265-272
- Associations between type 2 diabetes-related genetic scores and metabolic traits, in obese and normal-weight youths.J. Clin. Endocrinol. Metab. 2016; 101: 4244-4250
- One-year follow-up of untreated obese white children and adolescents with impaired glucose tolerance: high conversion rate to normal glucose tolerance.Diabet. Med. 2010; 27: 516-521
- Effect of a 10-week weight loss camp on fatty liver disease and insulin sensitivity in obese Danish children.J. Pedia Gastroenterol. Nutr. 2012; 54: 223-228
- Mechanisms linking obesity to insulin resistance and type 2 diabetes.Nature. 2006; 444: 840-846
- Puberty as an accelerator for diabetes complications.Pedia Diabetes. 2014; 15: 18-26
- Dysregulation of microRNA-125a contributes to obesity-associated insulin resistance and dysregulates lipid metabolism in mice.Biochim. Biophys. Acta Mol. Cell Biol. Lipids. 2020; 1865158640
- Renal olfactory receptor 1393 contributes to the progression of type 2 diabetes in a diet-induced obesity model.Am. J. Physiol. Ren. Physiol. 2019; 316: F372-F381
- High lipolytic activity and dyslipidemia in a spontaneous hypertensive/NIH corpulent (SHR/N-cp) rat: a genetic model of obesity and type 2 diabetes mellitus.J. Physiol. Biochem. 2009; 65: 33-41
- Characterization of Wnt1-inducible signaling pathway protein-1 in obese children and adolescents.Curr. Med. Sci. 2018; 38: 868-874
- Pathogenic factors of glucose intolerance in obese Japanese adolescents with type 2 diabetes.Metabolism. 2000; 49: 186-191
- Beta-cell function, insulin sensitivity, and glucose tolerance in obese diabetic and nondiabetic adolescents and young adults.J. Clin. Endocrinol. Metab. 2006; 91: 185-191
- Early-onset type 2 diabetes in obese white subjects is characterised by a marked defect in beta cell insulin secretion, severe insulin resistance and a lack of response to aerobic exercise training.Diabetologia. 2007; 50: 1500-1508
Article info
Publication history
Published online: September 29, 2022
Accepted:
September 16,
2022
Received in revised form:
August 15,
2022
Received:
April 11,
2022
Identification
Copyright
© 2022 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.
