Tian Hu1, David R Jacobs1, Alan R Sinaiko2, Lydia A Bazzano3, Trudy L Burns4, Stephen R Daniels5, Terry Dwyer6, Nina Hutri-Kähönen7, Markus Juonala8,9,10, Kari A Murdy2, Ronald J Prineas11, Olli T Raitakari12,13,14, Elaine M Urbina15,16, Alison Venn17, Jessica G Woo16,18, Julia Steinberger19. 1. Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN. 2. Department of Pediatrics, University of Minnesota School of Medicine, Minneapolis, MN. 3. Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA. 4. Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA. 5. Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO. 6. Oxford Martin School, Oxford University, Oxford, U.K. 7. Department of Pediatrics, Tampere University Hospital, and Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland. 8. Department of Internal Medicine, University of Turku, Turku, Finland. 9. Division of Medicine, Turku University Hospital, Turku, Finland. 10. Murdoch Children's Research Institute, Parkville, Victoria, Australia. 11. Division of Public Health Science, Wake Forest University, Winston-Salem, NC. 12. Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland. 13. Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland. 14. Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland. 15. The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH. 16. Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH. 17. Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia. 18. Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH. 19. Department of Pediatrics, University of Minnesota School of Medicine, Minneapolis, MN stein055@umn.edu.
Abstract
OBJECTIVE: To examine childhood BMI, fasting glucose, and insulin in relation to incident adult type 2 diabetes mellitus (T2DM). RESEARCH DESIGN AND METHODS: We used data from the International Childhood Cardiovascular Cohort (i3C) Consortium. Data included childhood (age 3-19 years) measurements obtained during the 1970s-1990s; a health questionnaire, including self-report of adult T2DM (occurrence age, medication use) obtained at mean age 40 years; and a medical diagnosis registry (Finland). RESULTS: The sample included 6,738 participants. Of these, 436 (6.5%) reported onset of T2DM between ages 20 and 59 (mean 40.8) years, and 86% of them reported use of a confirmed antidiabetic medication. BMI and glucose (age and sex standardized) were associated with incident T2DM after adjustment for cohort, country, sex, race, age, and calendar year of measurement. Increasing levels of childhood BMI and glucose were related to an incrementally increased risk of T2DM beginning at age 30 years, beginning at cut points <95th percentile for BMI and <100 mg/dL for glucose. Insulin was positively associated with adult T2DM after adjustment for BMI and glucose and added to T2DM discrimination. CONCLUSIONS: Childhood BMI and glucose are predictors of adult T2DM at levels previously considered to be within the normal range. These easy-to-apply measurements are appealing from a clinical perspective. Fasting insulin has the potential to be an additional predictor.
OBJECTIVE: To examine childhood BMI, fasting glucose, and insulin in relation to incident adult type 2 diabetes mellitus (T2DM). RESEARCH DESIGN AND METHODS: We used data from the International Childhood Cardiovascular Cohort (i3C) Consortium. Data included childhood (age 3-19 years) measurements obtained during the 1970s-1990s; a health questionnaire, including self-report of adult T2DM (occurrence age, medication use) obtained at mean age 40 years; and a medical diagnosis registry (Finland). RESULTS: The sample included 6,738 participants. Of these, 436 (6.5%) reported onset of T2DM between ages 20 and 59 (mean 40.8) years, and 86% of them reported use of a confirmed antidiabetic medication. BMI and glucose (age and sex standardized) were associated with incident T2DM after adjustment for cohort, country, sex, race, age, and calendar year of measurement. Increasing levels of childhood BMI and glucose were related to an incrementally increased risk of T2DM beginning at age 30 years, beginning at cut points <95th percentile for BMI and <100 mg/dL for glucose. Insulin was positively associated with adult T2DM after adjustment for BMI and glucose and added to T2DM discrimination. CONCLUSIONS: Childhood BMI and glucose are predictors of adult T2DM at levels previously considered to be within the normal range. These easy-to-apply measurements are appealing from a clinical perspective. Fasting insulin has the potential to be an additional predictor.
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