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Nham T, Read SH, Giannakeas V, Berger H, Feig DS, Fleming K, Ray JG, Rosella L, Shah BR, Lipscombe LL. The association between offspring birthweight and future risk of maternal diabetes: A population-based study. Diabet Med 2023; 40:e14991. [PMID: 36281547 DOI: 10.1111/dme.14991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 10/14/2022] [Indexed: 01/17/2023]
Abstract
AIMS As an indicator of maternal cardiometabolic health, newborn birthweight may be an important predictor of maternal type 2 diabetes mellitus (diabetes). We evaluated the relation between offspring birthweight and onset of maternal diabetes after pregnancy. METHODS This retrospective cohort study used linked population-based health databases from Ontario, Canada. We included women aged 16-50 years without pre-pregnancy diabetes, and who had a live birth between 2006 and 2014. We used Cox proportional hazard regression to evaluate the association between age- and sex-standardized offspring birthweight percentile categories and incident maternal diabetes, while adjusting for maternal age, parity, year, ethnicity, gestational diabetes (GDM) and hypertensive disorders of pregnancy (HDP). Results were further stratified by the presence of GDM in the index pregnancy. RESULTS Of 893,777 eligible participants, 14,329 (1.6%) women were diagnosed with diabetes over a median (IQR) of 4.4 (1.5-7.4) years of follow-up. There was a continuous positive relation between newborn birthweight above the 75th percentile and maternal diabetes. Relative to a birthweight between the 50th and 74.9th percentiles, women whose newborn had a birthweight between the 97th and 100th percentiles had an adjusted hazards ratio (aHR) of diabetes of 2.30 (95% CI 2.16-2.46), including an aHR of 2.01 (95% CI 1.83-2.21) among those with GDM, and 2.59 (2.36-2.84) in those without GDM. CONCLUSIONS A higher offspring birthweight signals an increased risk of maternal diabetes, offering another potentially useful way to identify women especially predisposed to diabetes.
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Affiliation(s)
- Tina Nham
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Stephanie H Read
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
| | - Vasily Giannakeas
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
| | - Howard Berger
- Department of Obstetrics and Gynecology, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Denice S Feig
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Sinai Health System, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Karen Fleming
- Department of Family and Community Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Joel G Ray
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Department of Obstetrics and Gynecology, St. Michael's Hospital, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Laura Rosella
- ICES, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Baiju R Shah
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Lorraine L Lipscombe
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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Haris B, Saraswathi S, Al‐Khawaga S, Hasnah R, Saeed A, Mundekkadan S, Hamed N, Afyouni H, Abdel‐Karim T, Mohammed S, Khalifa A, Al‐Maadheed M, Al‐Zyoud M, Shamekh A, Elawwa A, Al‐Khalaf F, Boughorbel S, Petrovski G, Hussain K. Epidemiology, genetic landscape and classification of childhood diabetes mellitus in the State of Qatar. J Diabetes Investig 2021; 12:2141-2148. [PMID: 34101350 PMCID: PMC8668069 DOI: 10.1111/jdi.13610] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 05/24/2021] [Accepted: 05/27/2021] [Indexed: 12/29/2022] Open
Abstract
AIMS/INTRODUCTION To study the epidemiology, genetic landscape and causes of childhood diabetes mellitus in the State of Qatar. MATERIALS AND METHODS All patients (aged 0-18 years) with diabetes mellitus underwent biochemical, immunological and genetic testing. American Diabetes Association guidelines were used to classify types of diabetes mellitus. The incidence and prevalence of all the different types of diabetes mellitus were calculated. RESULTS Total number of children with diabetes mellitus was 1,325 (type 1 n = 1,096, ≥1 antibody; type 2 n = 104, type 1B n = 53; maturity onset diabetes of the young n = 20; monogenic autoimmune n = 4; neonatal diabetes mellitus n = 10;, syndromic diabetes mellitus n = 23; and double diabetes mellitus n = 15). The incidence and prevalence of type 1 diabetes were 38.05 and 249.73 per 100,000, respectively, and for type 2 were 2.51 and 23.7 per 100,000, respectively. The incidence of neonatal diabetes mellitus was 34.4 per 1,000,000 live births, and in indigenous Qataris the incidence was 43.6 per 1,000,000 live births. The prevalence of type 1 diabetes and type 2 diabetes in Qatari children was double compared with other nationalities. The prevalence of maturity onset diabetes of the young in Qatar was 4.56 per 100,000. CONCLUSIONS This is the first prospective and comprehensive study to document the epidemiology and genetic landscape of childhood diabetes mellitus in this region. Qatar has the fourth highest incidence of type 1 diabetes mellitus, with the incidence and prevalence being higher in Qatari compared with non-Qatari. The prevalence of type 2 diabetes mellitus is also higher in Qatar than in Western countries. The incidence of neonatal diabetes mellitus is the second highest in the world. GCK is the most common form of maturity onset diabetes of the young, and a large number of patients have type 1B diabetes mellitus.
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Affiliation(s)
- Basma Haris
- Division of EndocrinologyDepartment of PediatricsSidra MedicineDohaQatar
| | - Saras Saraswathi
- Division of EndocrinologyDepartment of PediatricsSidra MedicineDohaQatar
| | - Sara Al‐Khawaga
- Division of EndocrinologyDepartment of PediatricsSidra MedicineDohaQatar
| | - Reem Hasnah
- Translational ResearchSidra MedicineDohaQatar
| | - Amira Saeed
- Translational ResearchSidra MedicineDohaQatar
| | - Shihab Mundekkadan
- Division of EndocrinologyDepartment of PediatricsSidra MedicineDohaQatar
| | - Noor Hamed
- Division of EndocrinologyDepartment of PediatricsSidra MedicineDohaQatar
| | - Houda Afyouni
- Division of EndocrinologyDepartment of PediatricsSidra MedicineDohaQatar
| | | | - Shayma Mohammed
- Division of EndocrinologyDepartment of PediatricsSidra MedicineDohaQatar
| | - Amel Khalifa
- Division of EndocrinologyDepartment of PediatricsSidra MedicineDohaQatar
| | - Maryam Al‐Maadheed
- Division of EndocrinologyDepartment of PediatricsSidra MedicineDohaQatar
| | - Mahmoud Al‐Zyoud
- Division of EndocrinologyDepartment of PediatricsSidra MedicineDohaQatar
| | - Ahmed Shamekh
- Division of EndocrinologyDepartment of PediatricsSidra MedicineDohaQatar
| | - Ahmed Elawwa
- Division of EndocrinologyDepartment of PediatricsSidra MedicineDohaQatar
| | - Fawziya Al‐Khalaf
- Division of EndocrinologyDepartment of PediatricsSidra MedicineDohaQatar
| | | | - Goran Petrovski
- Division of EndocrinologyDepartment of PediatricsSidra MedicineDohaQatar
| | - Khalid Hussain
- Division of EndocrinologyDepartment of PediatricsSidra MedicineDohaQatar
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Müllner E, Röhnisch HE, von Brömssen C, Moazzami AA. Metabolomics analysis reveals altered metabolites in lean compared with obese adolescents and additional metabolic shifts associated with hyperinsulinaemia and insulin resistance in obese adolescents: a cross-sectional study. Metabolomics 2021; 17:11. [PMID: 33438144 PMCID: PMC7803706 DOI: 10.1007/s11306-020-01759-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 12/09/2020] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Hyperinsulinaemia and insulin resistance (IR) are strongly associated with obesity and are forerunners of type 2 diabetes. Little is known about metabolic alterations separately associated with obesity, hyperinsulinaemia/IR and impaired glucose tolerance (IGT) in adolescents. OBJECTIVES To identify metabolic alterations associated with obesity, hyperinsulinaemia/IR and hyperinsulinaemia/IR combined with IGT in obese adolescents. METHODS 81 adolescents were stratified into four groups based on body mass index (lean vs. obese), insulin responses (normal insulin (NI) vs. high insulin (HI)) and glucose responses (normal glucose tolerance (NGT) vs. IGT) after an oral glucose tolerance test (OGTT). The groups comprised: (1) healthy lean with NI and NGT, (2) obese with NI and NGT, (3) obese with HI and NGT, and (4) obese with HI and IGT. Targeted nuclear magnetic resonance-based metabolomics analysis was performed on fasting and seven post-OGTT plasma samples, followed by univariate and multivariate statistical analyses. RESULTS Two groups of metabolites were identified: (1) Metabolites associated with insulin response level: adolescents with HI (groups 3-4) had higher concentrations of branched-chain amino acids and tyrosine, and lower concentrations of serine, glycine, myo-inositol and dimethylsulfone, than adolescents with NI (groups 1-2). (2) Metabolites associated with obesity status: obese adolescents (groups 2-4) had higher concentrations of acetylcarnitine, alanine, pyruvate and glutamate, and lower concentrations of acetate, than lean adolescents (group 1). CONCLUSIONS Obesity is associated with shifts in fat and energy metabolism. Hyperinsulinaemia/IR in obese adolescents is also associated with increased branched-chain and aromatic amino acids.
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Affiliation(s)
- Elisabeth Müllner
- Department of Molecular Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Hanna E Röhnisch
- Department of Molecular Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Claudia von Brömssen
- Department of Energy and Technology, Unit of Applied Statistics and Mathematics, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Ali A Moazzami
- Department of Molecular Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden.
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Li YF, Lin SJ, Chiang TL. Timing of rapid weight gain and its effect on subsequent overweight or obesity in childhood: findings from a longitudinal birth cohort study. BMC Pediatr 2020; 20:293. [PMID: 32532342 PMCID: PMC7291582 DOI: 10.1186/s12887-020-02184-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 06/01/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Rapid weight gain (RWG) has been recognized as an important determinant of childhood obesity. This study aims to explore the RWG distribution among children at six-month intervals from birth to two years old and to examine the association of RWG in each interval with overweight or obesity development in preschool- and school-aged children. METHODS Data were obtained from the Taiwan Birth Cohort Study, which is a nationally representative sample of 24,200 children who participated in a face-to-face survey. A total of 17,002 children had complete data both for weight and height at each of the five measurement time periods. Multivariable logistic regression models quantified the relationship between RWG and childhood overweight or obesity. RESULTS A total of 17.5% of children experienced rapid weight gain in the first six months of age, compared to only 1.8% of children from 18-24 months. RWG was significantly associated with an increased risk of developing overweight or obesity at 36 months (RWG birth-6 months: OR = 2.6, 95% CI: 2.3-2.8; RWG 18-24 months: OR = 3.7, 95% CI: 2.9-4.6), 66 months (RWG birth-6 months: OR = 2.2, 95% CI: 2.0-2.4; RWG 18-24 months: OR = 2.3, 95% CI: 1.8-2.8), and 8 years of age (RWG birth-6 months: OR = 1.7, 95% CI: 1.6-1.9; RWG 18-24 months: OR = 2.4, 95% CI: 2.0-3.0). CONCLUSIONS Childhood RWG increased the risk of subsequent overweight or obesity, regardless of the specific time interval at which RWG occurred before the age of two years. The results reinforce the importance of monitoring childhood RWG continuously and show the risks of childhood RWG with respect to the development of overweight or obesity at preschool and school ages.
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Affiliation(s)
- Yi-Fan Li
- Division of Clinical Chinese Medicine, National Research Institute of Chinese Medicine, Ministry of Health and Welfare in Taiwan, Taipei, Taiwan
| | - Shio-Jean Lin
- Department of Pediatrics, Chi Mei Medical Center, Taipei, Taiwan
| | - Tung-Liang Chiang
- Institute of Health Policy and Management, College of Public Health, National Taiwan University, Room 620, No. 17, Xu-Zhou Road, Taipei, Taiwan, 10055, Taiwan.
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Verma SK, Yadav YS, Thareja S. 2,4-Thiazolidinediones as PTP 1B Inhibitors: A Mini Review (2012-2018). Mini Rev Med Chem 2019; 19:591-598. [PMID: 30968766 DOI: 10.2174/1389557518666181026092029] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 10/18/2018] [Accepted: 10/19/2018] [Indexed: 12/16/2022]
Abstract
2,4-thiazolidinedione (TZD) scaffold is a synthetic versatile scaffold explored by medicinal chemists for the discovery of novel molecules for the target-specific approach to treat or manage number of deadly ailments. PTP 1B is the negative regulator of insulin signaling cascade, and its diminished activity results in abolishment of insulin resistance associated with T2DM. The present review focused on the seven years journey (2012-2018) of TZDs as PTP 1B inhibitors with the insight into the amendments in the structural framework of TZD scaffold in order to optimize/design potential PTP 1B inhibitors. We have investigated the synthesized molecules based on TZD scaffold with potential activity profile against PTP 1B. Based on the SAR studies, the combined essential pharmacophoric features of selective and potent TZDs have been mapped and presented herewith for further design and synthesis of novel inhibitors of PTP 1B. Compound 46 bearing TZD scaffold with N-methyl benzoic acid and 5-(3-methoxy-4-phenethoxy) benzylidene exhibited the most potent activity (IC50 1.1 µM). Imidazolidine-2,4-dione, isosteric analogue of TZD, substituted with 1-(2,4-dichlorobenzyl)-5-(3-(2,4- dichlorobenzyloxy)benzylidene) (Compound 15) also endowed with very good PTP inhibitory activity profile (IC50 0.57 µM). It is noteworthy that Z-configuration is essential in structural framework around the double bond of arylidene for the designing of bi-dentate ligands with optimum activity.
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Affiliation(s)
- Sant Kumar Verma
- School of Pharmaceutical Sciences, Guru Ghasidas Central University, Bilaspur- 495 009 (C.G.), India
| | - Yatesh Sharad Yadav
- School of Pharmaceutical Sciences, Guru Ghasidas Central University, Bilaspur- 495 009 (C.G.), India
| | - Suresh Thareja
- School of Pharmaceutical Sciences, Guru Ghasidas Central University, Bilaspur- 495 009 (C.G.), India
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Zhou QX, Wang ZY, Zhao HF, Wang S. The effects of GLP-1 analogues on pre-diabetes of the children. Exp Ther Med 2017; 13:1426-1430. [PMID: 28413488 PMCID: PMC5377282 DOI: 10.3892/etm.2017.4129] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Accepted: 11/29/2016] [Indexed: 12/24/2022] Open
Abstract
The aim of the study was to evaluate the clinical efficacy of glucagon-like peptide-1 (GLP-1) analogues in children of pre-diabetes to delay or reverse the development of pre-diabetes into the state of diabetes by early intervention. Prospective and randomized controlled clinical trials were performed in 42 cases of newly diagnosed pre-diabetes in children. The sample size was randomly divided into the two groups. The first group included 21 subjects comprising the lifestyle intervention group, i.e., control group, and the second group included 21 subjects comprising the lifestyle intervention+GLP-1 analogues liraglutide group, i.e., observation group. Interventions carried out lasted 3 months. A review of intervention was carried out at 1 month and after 3 months. Medical examinations were carried out at the the time following diagnosis with pre-diabetes and after the intervention of 3 months. The medical test examinations included the fasting blood glucose (FPG), 2-hour postprandial blood glucose (2hPG), detection of glycated hemoglobin A1c (HbA1C), total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), body mass index (BMI), insulin resistance (IR) and the islet cell functions. After 1 month of intervention, the observation group exhibited a better control on FPG and 2hPG compared with the control group (P<0.05). After 3 months of the intervention, FPG and 2hPG levels of the observation group were significantly lower than those of the control group (P<0.01). The levels of HbA1C, TC, TG, LDL-C, HDL-C, and BMI of the observation group were statistically better controlled, when compared with the control group after the intervention of 3 months. The IR index of the observation group was significantly decreased compared to that of the control group (P<0.05) and the islet function index of the β-cell of the observation group showed statistically higher values than that of the control group (P<0.05). In conclusion, GLP-1 analogues are a better regulator of blood sugar levels, effectively improve lipid profile, body mass, IR and islet β-cell function. Furthermore, GLP-1 analogues opens up a new way to intervene pre-diabetes in children.
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Affiliation(s)
- Qing-Xia Zhou
- Department of Pediatrics, Weifang People's Hospital, Weifang, Shandong 261041, P.R. China
| | - Zi-Yu Wang
- Department of Radiology, Yidu Central Hospital of Weifang, Weifang, Shandong 262500, P.R. China
| | - Hua-Feng Zhao
- Department of Pediatrics, Weifang People's Hospital, Weifang, Shandong 261041, P.R. China
| | - Shan Wang
- Department of Pediatrics, People's Hospital of Shouguang City, Shouguang, Shandong 262700, P.R. China
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Seed Ahmed M, Ahmed MS, Pelletier J, Leumann H, Gu HF, Östenson CG. Expression of Protein Kinase C Isoforms in Pancreatic Islets and Liver of Male Goto-Kakizaki Rats, a Model of Type 2 Diabetes. PLoS One 2015; 10:e0135781. [PMID: 26398746 PMCID: PMC4580567 DOI: 10.1371/journal.pone.0135781] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Accepted: 07/27/2015] [Indexed: 02/03/2023] Open
Abstract
Protein kinase C (PKC) is a family of protein kinases controlling protein phosphorylation and playing important roles in the regulation of metabolism. We have investigated expression levels of PKC isoforms in pancreatic islets and liver of diabetic Goto-Kakizaki (GK) rats with and without insulin treatment to evaluate their association with glucose homeostasis. mRNA and protein expression levels of PKC isoforms were assessed in pancreatic islets and liver of Wistar rats and GK rats with or without insulin treatment. PKCα and PKCζ mRNA expressions were down-regulated in islets of GK compared with Wistar rats. PKCα and phosphorylated PKCα (p-PKCα) protein expressions were decreased in islets of GK compared with insulin-treated GK and Wistar rats. PKCζ protein expression in islets was reduced in GK and insulin-treated GK compared with Wistar rats, but p-PKCζ was decreased only in GK rats. Islet PKCε mRNA and protein expressions were lower in GK compared with insulin-treated GK and Wistar rats. In liver, PKCδ and PKCζ mRNA expressions were decreased in both GK and insulin-treated GK compared with Wistar rats. Hepatic PKCζ protein expression was diminished in both GK rats with and without insulin treatment compared with Wistar rats. Hepatic PKCε mRNA expression was down-regulated in insulin-treated GK compared with GK and Wistar rats. PKCα, PKCε, and p-PKCζ expressions were secondary to hyperglycaemia in GK rat islets. Hepatic PKCδ and PKCζ mRNA expressions were primarily linked to hyperglycaemia. Additionally, hepatic PKCε mRNA expression could be under control of insulin.
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Affiliation(s)
- Mohammed Seed Ahmed
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Solna, Stockholm, Sweden; Department of Physiology, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | | | - Julien Pelletier
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Solna, Stockholm, Sweden
| | - Hannes Leumann
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Solna, Stockholm, Sweden
| | - Harvest F Gu
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Solna, Stockholm, Sweden
| | - Claes-Göran Östenson
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Solna, Stockholm, Sweden
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Al-Rubeaan K. National surveillance for type 1, type 2 diabetes and prediabetes among children and adolescents: a population-based study (SAUDI-DM). J Epidemiol Community Health 2015; 69:1045-51. [PMID: 26085648 PMCID: PMC4680138 DOI: 10.1136/jech-2015-205710] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 06/02/2015] [Indexed: 01/08/2023]
Abstract
Background There is a paucity of data on the national prevalence of diabetes and prediabetes among youth. The Saudi Abnormal Glucose Metabolism and Diabetes Impact Study (SAUDI-DM) was used to assess the prevalence of type 1 and type 2 diabetes as well as impaired fasting glucose (IFG) among children and adolescents. Methods Sociodemographic, anthropometric and clinical data were collected through a nationwide household randomly selected 23 523 children and adolescents aged ≤18 years. Known participants with diabetes were classified according to their diabetes type, while participants without diabetes were subjected to fasting plasma glucose assessment and patients with diabetes were identified using the American Diabetes Association (ADA) criteria. All the studied participants were tested for lipid parameters. Multivariate logistic regression analysis was used to assess different risk factors. Results The overall prevalence of diabetes was 10.84%, of which 0.45% were known type 1 and type 2 patients with diabetes and 10.39% were either newly identified cases of diabetes (4.27%) or IFG (6.12%) with more than 90% of the participants with diabetes being unaware of their disease. The prevalence of known type 1 and type 2 diabetes as well as the newly identified cases was higher than what has been reported internationally. Age, male gender, obesity, urban residency, high family income and presence of dyslipidaemia were found to be significant risk factors for diabetes and IFG. Conclusions Diabetes and IFG are highly prevalent in this society with the majority of the patients being unaware of their disease, which warrants urgent adoption of early detection, treatment and prevention programmes.
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Amed S. The future of treating youth-onset type 2 diabetes: focusing upstream and extending our influence into community environments. Curr Diab Rep 2015; 15:7. [PMID: 25644815 DOI: 10.1007/s11892-015-0576-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Type 2 diabetes (T2D) in youth is on the rise and many of these youth already have comorbidity at disease onset. The TODAY trial clearly demonstrated the challenges of treating this disease. Obesity is a key risk factor in the development of youth-onset T2D, and its prevention can mitigate the risk for developing T2D. However, childhood obesity prevention efforts to date have shown only modest effectiveness. Considering the larger, complex socioeconomic and cultural contexts that influence health behaviors among children and their families can enhance prevention efforts. Community-based participatory, multi-component, multi-setting childhood obesity prevention initiatives designed using the socio-ecological model and systems theory have been effective in sustainably decreasing childhood overweight and obesity. To advance our progress in treating and preventing T2D in youth, we must apply this new knowledge on community-wide childhood obesity prevention to enhance the impact of individual-level therapeutic strategies such as the TODAY intervention.
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Affiliation(s)
- Shazhan Amed
- Department of Pediatrics, BC Children's Hospital, Endocrinology & Diabetes Unit, University of British Columbia, 4480 Oak Street, Room K4-206, Vancouver, BC, V6H3V4, Canada,
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Baselga Torres E, Torres-Pradilla M. Cutaneous Manifestations in Children with Diabetes Mellitus and Obesity. ACTA ACUST UNITED AC 2014. [DOI: 10.1016/j.adengl.2014.05.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Cutaneous manifestations in children with diabetes mellitus and obesity. ACTAS DERMO-SIFILIOGRAFICAS 2014; 105:546-57. [PMID: 24698434 DOI: 10.1016/j.ad.2013.11.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2012] [Revised: 11/03/2013] [Accepted: 11/06/2013] [Indexed: 01/21/2023] Open
Abstract
Obesity and diabetes are chronic diseases that affect people all over the world, and their incidence is increasing in both children and adults. Clinically, they affect a number of organs, including the skin. The cutaneous manifestations caused or aggravated by obesity and diabetes are varied and usually bear some relation to the time that has elapsed since the onset of the disease. They include soft fibromas, acanthosis nigricans, striae, xerosis, keratosis pilaris, plantar hyperkeratosis, fungal and bacterial skin infections, granuloma annulare, necrobiosis lipoidica, psoriasis, and atopic dermatitis. In this review article we present the skin changes found in children with diabetes mellitus and obesity and related syndromes and highlight the importance of the skin as a tool for establishing clinical suspicion and early diagnosis of systemic disease.
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Abstract
BACKGROUND Active commuting to school (ACS; walking or cycling to school) appears promising for decreasing children's obesity risk, although long-term studies are sparse. The aim was to examine whether kindergarten ACS was associated with fifth-grade adiposity. METHODS This study was a secondary analysis of the Early Childhood Longitudinal Study, Kindergarten (n=7938). Enrollment in kindergarten (1998-1999) was nationally representative of the United States and follow-up occurred in 2004. Kindergarten ACS was the main exposure variable and fifth-grade BMI z-score was the main outcome measure. Covariates included (1) neighborhood safety and BMI z-score in kindergarten and (2) demographics (i.e., age, gender, race/ethnicity, socioeconomic status, single- vs. two-parent households, region of country, and urbanicity in fifth grade). Three interactions were included: school travel*neighborhood safety; school travel*BMI z-score (kindergarten); and school travel*socioeconomic status. Analysis of covariance accounted for the complex sampling design. RESULTS Kindergarten ACS was associated with lower BMI z-score in fifth grade. The interaction of school travel*neighborhood safety indicated that children from less-safe neighborhoods who did ACS in kindergarten had a lower fifth-grade BMI z-score (p<0.05) than their peers who did not do ACS in kindergarten (i.e., in terms of BMI, this difference was -0.49 kg/m(2) for children of average height in less-safe neighborhoods). CONCLUSION Among children from less-safe neighborhoods, kindergarten ACS independently predicted lower BMI z-score in fifth grade among a national US cohort. Interventions and policies to increase ACS among young children, especially from unsafe neighborhoods, are warranted and should address parents' safety concerns.
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Affiliation(s)
- Jason A. Mendoza
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX.,Academic General Pediatrics, Department of Pediatrics, Baylor College of Medicine, Houston, TX.,Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, TX.,Present affiliation: Jason A. Mendoza, MD, MPH, Associate Professor of Pediatrics, University of Washington and Principal Investigator, Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, WA
| | - Yan Liu
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX
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Seed Ahmed M, Kovoor A, Nordman S, Abu Seman N, Gu T, Efendic S, Brismar K, Östenson CG, Gu HF. Increased expression of adenylyl cyclase 3 in pancreatic islets and central nervous system of diabetic Goto-Kakizaki rats: a possible regulatory role in glucose homeostasis. Islets 2012; 4:343-8. [PMID: 23018249 PMCID: PMC3524141 DOI: 10.4161/isl.22283] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Adenylyl cyclase 3 (AC3) is expressed in pancreatic islets of the Goto-Kakizaki (GK) rat, a spontaneous animal model of type 2 diabetes (T2D), and also exerts genetic effects on the regulation of body weight in man. In addition to pancreatic islets, the central nervous system (CNS) plays an important role in the pathogenesis of T2D and obesity by regulating feeding behavior, body weight and glucose metabolism. In the present study, we have investigated AC3 expression in pancreatic islets, striatum and hypothalamus of GK rats to evaluate its role in the regulation of glucose homeostasis. GK and Wistar rats at the age of 2.5 mo were used. A group of GK rats were implanted with sustained insulin release chips for 15 d. Plasma glucose and serum insulin levels were measured. AC3 gene expression levels in pancreatic islets, striatum and hypothalamus were determined by using real-time RT-PCR. Results indicated that plasma glucose levels in Wistar rats were found to be similar to insulin-treated GK rats, and significantly lower compared with non-treated GK rats. AC3 expression levels in pancreatic islets, striatum and hypothalamus of GK rats were higher compared with Wistar rats, while the levels were intermediate in insulin-treated GK rats. The AC3 expression display patterns between pancreatic islets and striatum-hypothalamus were similar. The present study thus provides the first evidence that AC3 is overexpressed in the regions of striatum and hypothalamus of brain, and similarly in pancreatic islets of GK rats suggesting that AC3 plays a role in regulation of glucose homeostasis via CNS and insulin secretion.
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Affiliation(s)
- Mohammed Seed Ahmed
- Department of Molecular Medicine and Surgery; Karolinska Institutet; Karolinska University Hospital; Stockholm, Sweden
| | - Abraham Kovoor
- Department of Biomedical and Pharmaceutical Sciences; University of Rhode Island; Kingston, RI USA
| | - Sofia Nordman
- Department of Molecular Medicine and Surgery; Karolinska Institutet; Karolinska University Hospital; Stockholm, Sweden
| | - Norhashimah Abu Seman
- Department of Molecular Medicine and Surgery; Karolinska Institutet; Karolinska University Hospital; Stockholm, Sweden
| | - Tianwei Gu
- Department of Molecular Medicine and Surgery; Karolinska Institutet; Karolinska University Hospital; Stockholm, Sweden
| | - Suad Efendic
- Department of Molecular Medicine and Surgery; Karolinska Institutet; Karolinska University Hospital; Stockholm, Sweden
| | - Kerstin Brismar
- Department of Molecular Medicine and Surgery; Karolinska Institutet; Karolinska University Hospital; Stockholm, Sweden
| | - Claes-Göran Östenson
- Department of Molecular Medicine and Surgery; Karolinska Institutet; Karolinska University Hospital; Stockholm, Sweden
| | - Harvest F. Gu
- Department of Molecular Medicine and Surgery; Karolinska Institutet; Karolinska University Hospital; Stockholm, Sweden
- Correspondence to: Harvest F. Gu,
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Wilkin TJ. The convergence of type 1 and type 2 diabetes in childhood: the accelerator hypothesis. Pediatr Diabetes 2012; 13:334-9. [PMID: 22059423 DOI: 10.1111/j.1399-5448.2011.00831.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2011] [Accepted: 09/27/2012] [Indexed: 12/21/2022] Open
Abstract
It seems likely that type 1 and type 2 diabetes lie at different points of the same spectrum, separated by the misunderstanding that one belongs to childhood and the other to adulthood. The spectrum is that of tempo--the rate at which beta cell function is lost over time. A combination of beta cell up-regulation (insulin demand, largely determined by obesity) and the genetically-determined immune response to it ('autoimmunity') determines tempo, ranging from slow to fast with every variant in between. There is good evidence that people who go on to develop type 1 (fast) diabetes are, like those who develop type 2 (slow diabetes), insulin resistant, and overwhelming evidence that body mass plays a key role. The prevention of type 1 diabetes may lie in weight restriction from an early age.
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Affiliation(s)
- T J Wilkin
- University Medicine, Level 7, Derriford Hospital, Plymouth, UK.
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15
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Kang LS, Nurkiewicz TR, Wu G, Boegehold MA. Changes in eNOS phosphorylation contribute to increased arteriolar NO release during juvenile growth. Am J Physiol Heart Circ Physiol 2012; 302:H560-6. [PMID: 22140037 PMCID: PMC3353788 DOI: 10.1152/ajpheart.00277.2011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2011] [Accepted: 11/14/2011] [Indexed: 02/07/2023]
Abstract
Nitric oxide (NO) mediates a major portion of arteriolar endothelium-dependent dilation in adults, but indirect evidence has suggested that NO contributes minimally to these responses in the young. Isolated segments of arterioles were studied in vitro to verify this age-related increase in NO release and investigate the mechanism by which it occurs. Directly measured NO release induced by ACh or the Ca(2+) ionophore A-23187 was five- to sixfold higher in gracilis muscle arterioles from 42- to 46-day-old (juvenile) rats than in those from 25- to 28-day-old (weanling) rats. There were no differences between groups in arteriolar endothelial NO synthase (eNOS) expression or tetrahydrobiopterin levels, and arteriolar l-arginine levels were lower in juvenile vessels than in weanling vessels (104 ± 6 vs.126 ± 3 pmol/mg). In contrast, agonist-induced eNOS Thr(495) dephosphorylation and eNOS Ser(1177) phosphorylation (events required for maximal activity) were up to 30% and 65% greater, respectively, in juvenile vessels. Juvenile vessels did not show increased expression of enzymes that mediate these events [protein phosphatases 1 and 2A and PKA and PKB (Akt)] or heat shock protein 90, which facilitates Ser(1177) phosphorylation. However, agonist-induced colocalization of heat shock protein 90 with eNOS was 34-66% greater in juvenile vessels than in weanling vessels, and abolition of this difference with geldanamycin also abolished the difference in Ser(1177) phosphorylation between groups. These findings suggest that growth-related increases in arteriolar NO bioavailability may be due at least partially to changes in the regulation of eNOS phosphorylation and increased signaling activity, with no change in the abundance of eNOS signaling proteins.
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Affiliation(s)
- Lori S Kang
- Center for Cardiovascular and Respiratory Sciences, West Virginia Univ. School of Medicine, 1 Medical Center Dr., PO Box 9105, Morgantown, WV 26506-9105, USA
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Abstract
Over the past 2 decades, the prevalence of obesity and type 2 diabetes mellitus (T2DM) in children and adolescents has risen to epidemic proportions and disproportionately affects racial and ethnic minorities, who are at greater risk. The pathophysiology of T2DM is complex and involves insulin resistance, pancreatic β-cell dysfunction, and visceral adiposity. Current treatments of T2DM are limited to lifestyle intervention, metformin, and insulin therapy; use of these strategies in combination is often most effective. The role of research is to uncover simple biomarkers for insulin sensitivity and optimal and innovative treatment of insulin resistance and T2DM.
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Affiliation(s)
- Grace Kim
- Department of Pediatrics, Yale University School of Medicine, New Haven, CT 06520, USA
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17
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Amed S, Dean H, Sellers EAC, Panagiotopoulos C, Shah BR, Booth GL, Laubscher TA, Dannenbaum D, Hadjiyannakis S, Hamilton JK. Risk factors for medication-induced diabetes and type 2 diabetes. J Pediatr 2011; 159:291-6. [PMID: 21353243 DOI: 10.1016/j.jpeds.2011.01.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2010] [Revised: 12/13/2010] [Accepted: 01/11/2011] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To compare the prevalence of risk factors in children aged <18 years diagnosed with medication-induced diabetes mellitus versus those diagnosed with type 2 diabetes. STUDY DESIGN This retrospective observational study used data from a Canadian prospective surveillance study in which clinical features of new cases of type 2 diabetes (n = 225) and medication-induced diabetes (n = 58) were reported over a 2-year period. The presence of risk factors for type 2 diabetes (eg, obesity, family history of type 2 diabetes, ethnicity, acanthosis nigricans, hypertension, polycystic ovarian syndrome) was compared in the 2 groups using descriptive statistics and logistic regression. RESULTS Compared with the children with type 2 diabetes, the children with medication-induced diabetes were more likely to be Caucasian (P < .0001) and less likely to be obese (P < .0001), to have a positive family history of type 2 diabetes (P = .0001), to have acanthosis nigricans (P < .0001) on clinical examination, and to have an obesity-related comorbidity, such as polycystic ovarian syndrome (P = .04), dyslipidemia (P = .02), hypertension (P = .04), or an elevated alanine aminotransferase level (P = .05). CONCLUSIONS Evaluating for the typical risk factors for type 2 diabetes is not sufficient to identify all children at risk for developing medication-induced diabetes. Further studies are needed to help inform guidelines on screening for and prevention of medication-induced diabetes in children.
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Affiliation(s)
- Shazhan Amed
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
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18
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Rahman T, Cushing RA, Jackson RJ. Contributions of built environment to childhood obesity. ACTA ACUST UNITED AC 2011; 78:49-57. [PMID: 21259262 DOI: 10.1002/msj.20235] [Citation(s) in RCA: 126] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
As childhood obesity has reached epidemic proportions, it is critical to devise interventions that target the root causes of obesity and its risk factors. The two main components of childhood obesity are physical inactivity and improper nutrition, and it is becoming increasingly evident that the built environment can determine the level of exposure to these risk factors. Through a multidisciplinary literature review, we investigated the association between various built environment attributes and childhood obesity. We found that neighborhood features such as walkability/bikeability, mixed land use, accessible destinations, and transit increase resident physical activity; also that access to high-caloric foods and convenience stores increases risk of overweight and obesity, whereas the presence of neighborhood supermarkets and farmers' markets is associated with lower childhood body mass index and overweight status. It is evident that a child's built environment impacts his access to nutritious foods and physical activity. In order for children, as well as adults, to prevent onset of overweight or obesity, they need safe places to be active and local markets that offer affordable, healthy food options. Interventions that are designed to provide safe, walkable neighborhoods with access to necessary destinations will be effective in combating the epidemic of obesity.
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Affiliation(s)
- Tamanna Rahman
- University of California at Los Angeles School of Public Health, Los Angeles, CA, USA
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Kim JY, Kim ES, Jeon JY, Jekal Y. Improved Insulin Resistance, Adiponectin and Liver Enzymes without Change in Plasma Vaspin Level after 12 Weeks of Exercise Training among Obese Male Adolescents. ACTA ACUST UNITED AC 2011. [DOI: 10.7570/kjo.2011.20.3.138] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- Ji Young Kim
- Department of Sport and Leisure Studies, Yonsei University, Korea
| | - Eun Sung Kim
- Department of Sport and Leisure Studies, Yonsei University, Korea
| | - Justin Y. Jeon
- Department of Sport and Leisure Studies, Yonsei University, Korea
| | - Yoonsuk Jekal
- Department of Exercise and Sports Science, Jeju National University, Korea
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20
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Abstract
OBJECTIVE Type 2 diabetes is a common disease, afflicting more than 20 million Americans. Psychiatric disorders, particularly depression, have been previously correlated with diabetes. METHODS The objectives of this study were to determine the frequency of psychiatric illnesses in a type 2 pediatric diabetic cohort and to examine if there were any significant demographic differences between diabetic children with psychiatric disorders and diabetic children without psychiatric disorders. A retrospective chart review was performed on patients from two southeastern children's hospitals. RESULTS In our study, 26.2% (67 of 256) of diabetic patients were diagnosed with neuropsychiatric disorders (NPD). A comparison between gender frequencies of affected and unaffected patients suggested a statistical difference (P = 0.009). It appears that pediatric diabetic males are affected with NPD to a greater extent than females. Patients diagnosed with neurological disorders showed a body mass index average of 39.03, which was statistically different from non-diagnosed NPD patients (P = 0.0313). CONCLUSIONS To our knowledge, this is the first report to demonstrate the frequency of psychiatric disorders in a cohort of pediatric type 2 diabetics in the southeastern US. This study provides information regarding children afflicted with type 2 diabetes mellitus and the frequency of neuropsychiatric morbidities. This information may be useful for crafting future health policies and quality improvement interventions.
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Vasconcelos HCAD, Araújo MFMD, Damasceno MMC, Almeida PCD, Freitas RWJFD. Fatores de risco para diabetes mellitus tipo 2 entre adolescentes. Rev Esc Enferm USP 2010; 44:881-7. [DOI: 10.1590/s0080-62342010000400004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
O estudo teve como objetivo identificar fatores de risco para diabetes tipo 2 (DM 2) em uma população de adolescentes de escolas particulares de Fortaleza, Brasil. Foram avaliados 794 alunos, de 12 a 17 anos, em doze escolas, nos meses de maio, junho, agosto e setembro de 2007. Aplicou-se um formulário abordando aspectos sociodemográficos, IMC, pressão arterial, glicemia capilar e sedentarismo. Aproximadamente 24% dos participantes tinham o IMC elevado, 65% eram sedentários e 51% tinham antecedentes familiares de DM 2. Naqueles com maior renda, 73,5% tinham antecedentes familiares de DM 2 (p=0,04). Por volta de 39% dos adolescentes apresentavam pelo menos dois fatores de risco para DM 2. A maior parte dos fatores de risco para DM 2, identificados neste estudo, são modificáveis, portanto passíveis de intervenções preventivas no contexto escolar.
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