Adolescent metabolic syndrome and its components associations with incidence of type 2 diabetes in early adulthood: Tehran lipid and glucose study

Golaleh Asghari,Fereidoun Azizi,Parvin Mirmiran,Mohammad Karim Shahrzad,Mitra Hasheminia,Abolfazl Heidari,Kamran Guity,Farzad Hadaegh

doi:10.1186/s13098-020-00608-1

Abstract

AimTo investigate the association of youth metabolic syndrome (MetS) and its components, individually and in combination with early adulthood incident type 2 diabetes (T2DM).MethodsA total of 2798 adolescents aged 11–19 years enrolled in the study. At baseline, MetS, its components including blood pressure (BP), waist circumference (WC), triglycerides (TGs), fasting plasma glucose, and low HDL-C, and different combinations of MetS components were defined. After a mean 11.3 years of follow-up, T2DM was determined. Multivariable Cox proportional hazard regression analysis adjusted for age, sex, family history of T2DM, and adult BMI was used for data analysis. The hazard ratio (HR) and 95% confidence interval (CI) were reported.ResultsDuring the follow-up, 44 incidents T2DM were developed. Among different individual components, only high WC [HR = 2.63, 95% CI (1.39–4.97)] and high TGs [HR = 1.82, 95% CI (1.00–3.34)] remained as significant predictors only in the age and sex adjusted model. Regarding combinations of MetS components, ‘high TGs and high WC’ [HR = 2.70, 95% CI (1.27–5.77)], ‘high BP and high WC’ [HR = 2.52, 95% CI (1.00–6.33)], ‘high TGs and high BP’ [HR = 2.27, 95% CI (1.02–5.05)] as well as MetS per se [HR = 2.82, 95% CI (1.41–5.64)] had a significant relationship with incident T2DM in the multivariable adjusted model. Among different confounders, being female and having family history of T2DM were consistently associated with higher risk of T2DM, in different combinations of MetS components.ConclusionsAdolescence MetS and some combinations of MetS components predicted early adulthood T2DM. Thus, adolescents, particularly female ones, with combinations of MetS components as well as those with family history of T2DM could be targeted for lifestyle intervention.

Highlights

Metabolic syndrome (MetS) is considered as clustering of metabolic disorders including elevated blood pressure, abdominal obesity, hyperglycemia, and dyslipidemia [1] and rising trends of excess weight and MetS in adolescents is an alarming global concern [2]
Limited studies with different definitions of MetS, mostly without information on waist circumference (WC) investigating which definition could be a better predictor of incidence of chronic disease in adults, indicated that generally MetS among youth cannot be a better predictor than high Body mass index (BMI) or overweight and obesity for prediction of adult outcomes [11]
Participants with missing anthropometrical and biomechanical data (n = 254), diabetes at baseline (n = 8) and without any follow-up after recruitment (n = 801) were excluded from the analyses, the final analysis was conducted in 2798 participants

Summary

Introduction

Metabolic syndrome (MetS) is considered as clustering of metabolic disorders including elevated blood pressure, abdominal obesity, hyperglycemia, and dyslipidemia [1] and rising trends of excess weight and MetS in adolescents is an alarming global concern [2]. In Iran, the estimated the national prevalence of diabetes in 2011 was 11.4%, which increased by 35% of reported values in 2005 among adult population [7]. Contribution of each adolescent MetS components to risk of adult T2DM has been rarely considered [11, 13]. Magnussen et al [13] in a study indicated that persistent MetS versus spontaneous resolution from MetS in youth increased risk of T2DM by 30–78% in adults. Limited studies with different definitions of MetS, mostly without information on waist circumference (WC) investigating which definition could be a better predictor of incidence of chronic disease in adults, indicated that generally MetS among youth cannot be a better predictor than high BMI or overweight and obesity for prediction of adult outcomes [11]. There has not been an accurate and comprehensive examination about which combination of components can be more important in the development of adult T2DM

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