Prevalência de pré-diabetes e fatores de risco para diabetes mellitus tipo 2 em adolescentes e características associadas a esta condição

Abstract

Introduction: Type 2 diabetes mellitus (DM2) has reached an increasing number of children and adolescents worldwide. In Brazil, there are few studies related to the prevalence of high risk for diabetes (prediabetes) and associated factors in this public. Objective: To determine the prevalence of prediabetes and risk factors for type 2 diabetes mellitus among adolescent and characteristics associated with this condition. Methods: Transversal research with a quantitative approach, involving 553 adolescents (15-19 years) from public high schools in the city of Campina Grande, Paraíba. Data collection was conducted from September 2012 to June 2013, through the application form for obtaining demographic data, behavioral factors (sedentary lifestyle and physical activity) and family histor y of type 2 diabetes; conducting anthropometric (weight, height and abdominal circumference); measurement of blood pressure and blood collection (Glycated hemoglobin, fasting blood glucose and lipid profile). It was considered prediabetes the presence of HbA1c ≥ 5.7 and / or fasting glucose ≥ 100 mg / dL and, for evaluation of the presence of risk factors, it was adopted the criteria mentioned by the American Diabetes Association (ADA) and by the European Association for Diabetes Study. For classification of the group at risk for the development of T2DM it was considered the criteria adopted by ADA. Data were double entered and submitted for validation through the Epi Info 6.04 validate sub-program. Through the Statistical Package for Social Sciences (SPSS, version 22.0), a descriptive analysis of all variables was performed using the measurements of absolute and relative frequency. The distribution of these variables and association analysis took place according to the nutritional status and the presence or absence of abnormal HbA1C (prediabetes) among adolescents, using the chi-square test. For those variables that were associated with the prediabetic state, it was analyzed their independence in determining this condition, through the multivariate logistic regression test. All statistical analyzes considered the 95% confidence interval. Results: Among the adolescents evaluated, 19.3% were overweight / obese. Prediabetes was more common among those who were overweight (8.4%), but it was also present among those who were eutrophic (4.9%). In relation to the lifestyle, 53.4% were sedentary and 60.2% physically inactive. Among the risk factors recommended by the ADA, the most frequent were low HDL cholesterol (42.3%) and total cholesterol (21.0%). Only high triglyceride level was associated with prediabetes, but it did not appear as a predictor of this condition. Conclusions: The finding of a considerable prevalence of type 2 prediabetes among adolescents, including the eutrophic one, reinforces the importance of screening of this condition in this age group, regardless of nutritional status. It is important to conduct longitudinal studies to assess causality and the risk of developing type 2 diabetes among those with prediabetes.