Prevalence of Pre-Diabetes and Its Association With Clustering of Cardiometabolic Risk Factors and Hyperinsulinemia Among US Adolescents National Health and Nutrition Examination Survey 2005-2006

OBJECTIVE - Impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT) are considered to constitute "pre-diabetes." 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-h glucose during an oral glucose tolerance test to assess the prevalence of IFG, IGT, and pre-diabetes and used the log-binomial model to estimate the prevalence ratios (PRs) and 95% CIs. RESULTS - The unadjusted prevalences of IFG, IGT, and pre-diabetes were 13.1, 3.4, and 16.1%, respectively. Boys had a 2.4-fold higher prevalence of pre-diabetes 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 (0.6, 0.4-0.9). Overweight adolescents had a 2.6-fold higher rate than those with normal weight (1.3-5.1). Adolescents with two or more cardiometabolic risk factors had a 2.7-fold higher rate than those with none (1.5-4.8). Adolescents with hyperinsulinemia had a fourfold higher prevalence (2.2-7.4) than those without. Neither overweight nor number of cardiometabolic risk factors was significantly associated with pre-diabetes after adjustment for hyperinsulinemia. CONCLUSIONS - Pre-diabetes was highly prevalent among adolescents. Hyperinsulinemia was independently associated With pre-diabetes and may account for the association of overweight and clustering of cardiometabolic risk factors with pre-diabetes.