Incidence and predictors of early adulthood pre-diabetes/type 2 diabetes, among Iranian adolescents: the Tehran Lipid and Glucose Study

Purpose: To evaluate the incidence and predictors of early adulthood pre-diabetes/type 2 diabetes (T2D) among Iranian adolescents during a median follow-up of 9.2 yr. Method: A total of 2563 subjects aged 10-19 yr, without pre-diabetes/T2D at baseline, were entered in the study. Pre-diabetes was defined as those with fasting plasma glucose (FPG) 5.6 to <7 mmol/L. T2D was defined as anti-T2D drug consumption or FPG >= 7 mmol/L. Multivariate Cox-proportional analysis was applied to examine the association between different risk factors that showed attained statistical significance <0.2 in univariate analysis, with incident pre-diabetes/T2D. Same method was repeated on 1803 subjects with complete parental data to find the relation between parental risk factors and pre-diabetes/T2D. Result: The mean age of participants was 14.45 +/- 2.78 yr, and 53.6% were female. During follow-up 208 cases of pre-diabetes/T2D occurred, resulting in an incidence rate of 9.61 per 1000 person-years. Multivariate-adjusted hazard ratios (HRs) for incident pre-diabetes/T2D showed significant risk for 1 standard deviation increase in FPG and body mass index with corresponding HR of 1.89 (1.6-2.23) and 1.435 (1.080-1.905), respectively. Among parental potential risk factors, the paternal history of T2D was independently associated with increased risk for pre-diabetes/T2D in the adolescence (HR = 1.63(1.02-2.60)). Conclusion: About 1% of Iranian adolescents developed pre-diabetes/T2D each year. Among the non-modifiable risk factors paternal history of T2D and, among modifiable risk factors, the presence of general adiposity as well as the higher level of FPG should be considered among adolescents for development of pre-diabetes/T2D later in the young adulthood.