Prevalence of Prediabetes and Its Association with Clustering of Cardiometabolic Risk Factors and Hyperinsulinemia Among U.S. Adolescents: National Health and Nutrition Examination Survey 2005-2006

Abstract

Objective: Impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT) are considered to constitute “prediabetes.” We estimated the prevalence of IFG, IGT, and prediabetes among U.S. adolescents using data from a nationally representative sample.

Research Design and Methods: We analyzed data from participants aged 12-19 years in the National Health and Nutrition Examination Survey 2005-2006. We used fasting plasma glucose and 2-hour glucose during an oral glucose tolerance test to assess the prevalence of IFG, IGT, and prediabetes and used the log-binomial model to estimate the prevalence ratios (PRs) and 95% confidence intervals (CIs).

Results: The unadjusted prevalence of IFG, IGT, and prediabetes was 13.1%, 3.4%, and 16.1%, respectively. Boys had a 2.4-fold higher prevalence of prediabetes than girls (95% CI, 1.3-4.3). Non-Hispanic blacks had a lower rate than non-Hispanic whites (PR, 0.6; 95% CI, 0.4-0.9). Adolescents aged 16-19 years had a lower rate than those aged 12-15 years (PR, 0.6; 95% CI, 0.4-0.9). Overweight adolescents had a 2.6-fold higher rate than those with normal weight (95% CI 1.3-5.1). Adolescents with two or more cardiometabolic risk factors had 2.7-fold higher rate than those with none (95% CI, 1.5-4.8). Adolescents with hyperinsulinemia had a 4-fold higher prevalence (95% CI, 2.2-7.4) than those without. Neither overweight nor number of cardiometabolic risk factors was significantly associated with prediabetes after adjustment for hyperinsulinemia.

Conclusions: Prediabetes was highly prevalent among adolescents. Hyperinsulinemia was independently associated with prediabetes and may account for the association of overweight and clustering of cardiometabolic risk factors with prediabetes.