Abstract
BackgroundSouth-Asian's are predisposed to early onset type 2 diabetes (T2DM). The prevalence of cardio-metabolic risk-factors in young Sri-Lankans is unknown.Methodology/Principal FindingsTo determine by questionnaire and anthropometry the prevalence of first degree family history (FH) of T2DM, physical inactivity, raised waist circumference (WC) and raised body mass index (BMI) in a representative healthy urban population selected by cluster sampling. Those with ≥2 risk-factors were evaluated for metabolic syndrome (MS) and recruited for an intervention trial. Of 23,296 participants screened, 22,507 (53% Female) were eligible [8,497 aged 10–14 yrs, 4,763 aged 15–19 yrs and 9,247 aged 20–40 yrs]. 51% had none of the 4 risk-factors, 26% 1 risk-factor and 23% (5,163) ≥2 risk-factors of whom 4,532 were assessed for MS. Raised BMI was noted in 19.7% aged 10–14 yrs, 15.3% between 15–19 yrs, and between 20–40 yrs, 27.4% of males vs. 21.8% of females p<0.001. Prevalence of raised WC was greater in females for each age group: 42.7% vs. 32.1%; 28.1% vs. 16.1%; 34.5% vs. 25.7% (p<0.05 for all) as was physical inactivity: 39.9% vs. 14.5%; 51.7% vs. 20.0%; 62.7% vs. 41.3% which rose in both sexes with age (p<0.05 for all). FH of T2DM was present in 26.2%. In 4532 (50%<16 yrs) with ≥2 risk-factors, impaired fasting glycaemia/impaired glucose tolerance (pre-diabetes) prevalence was 16%. MS was more prevalent in males [10–16 yrs (13.0% vs. 8.8%), 16–40 yrs (29.5% vs. 20.0%) p<0.001 for both].Conclusions/SignificanceThere is a high prevalence of modifiable cardio-metabolic risk-factors in young urban Sri-Lankans with significant gender differences. A primary prevention intervention trial is ongoing in this cohort. Clinical Trial Registration Number SLCTR/2008/World Health Organization (WHO) international clinical trial registry platform.
Highlights
Type 2 Diabetes Mellitus (T2DM) and associated cardiovascular complications pose a major health care burden worldwide
In parallel there is an epidemic of pre-diabetes [impaired glucose tolerance (IGT) and impaired fasting glycaemia (IFG)] with prevalence rates between 10–15% reported in South Asian adult populations [1]
Metabolic syndrome was diagnosed in 13.0% of males and 8.8% of females below 16 years (p = 0.005) and in 29.5% of males and 20.0% of females over 16 years (p,0.001). This is the first large population based study to determine the prevalence of T2DM, pre-diabetes (IGT and IFG), and cardiometabolic risk factors in young urban Sri-Lankans
Summary
Type 2 Diabetes Mellitus (T2DM) and associated cardiovascular complications pose a major health care burden worldwide. T2DM and IGT are associated with a significantly increased risk of cardiovascular disease (CVD) with South Asian’s predisposed to early onset of T2DM and CVD, with almost a third of future T2DM cases predicted to be in those below 45 years [1]. Both CVD and T2DM may share a common pathogenesis and retain many common risk factors/features [1,2]. The most recent national study in subjects aged over 20 years indicated a population prevalence of dysglycaemia (defined as T2DM or IGT or IFG) of 20% which rose to 30% in urban areas [4]. The prevalence of cardio-metabolic riskfactors in young Sri-Lankans is unknown
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