Obesity and family history of diabetes as risk factors of impaired fasting glucose: implications for the early detection of prediabetes

Abstract

To determine whether the association between family history of diabetes (FHD) and impaired fasting glucose (IFG) is independent of body mass index (BMI) in children and adolescents. In all 443 (11.9%) children and adolescents with FHD, and 3280 (88.1%) without FHD were enrolled in a population-based cross-sectional study. Eligible subjects to participate were apparently healthy children and adolescents aged 7-15 yr from Middle and Northern Mexico. Obesity was defined by age- and gender-specific BMI >or= 95th percentile. FHD was defined as positive if at least one first degree relative had diabetes. The IFG was defined by fasting plasma glucose >or= 100 mg/dL and < 126 mg/dL. IFG was identified in 390 (88.0%) and 62 (1.9%) children and adolescents with and without FHD, respectively. In the group with positive FHD, IFG was diagnosed in 146 (37.4%), 79 (20.2%), and 165 (42.3%) children and adolescents who were obese, overweight, and normal-weight, respectively. On the other hand, in the group without FHD, IFG was identified in 21 (33.9%), 14 (22.6%), and 27 (43.5%) children and adolescents who were obese, overweight, and normal-weight, respectively. In the overall population, the age-, sex-, and BMI-adjusted logistic regression analysis showed a strong and independent association between FHD and IFG [odds ratio (OR) -11.7; 95% CI 9.5-21.2]. This association remained strong for girls and boys in a subsequent analysis stratified for BMI category. The presence of FHD in a first degree relative is associated with IFG, even in the absence of obesity.