i3C_diabetes_Supp_tables_final_.pdf (122.99 kB)

Childhood Body Mass Index and Fasting Glucose and Insulin Predict Adult Type-2 Diabetes: The International Childhood Cardiovascular Cohort (i3C) Consortium

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posted on 01.09.2020 by Tian Hu, David R. Jacobs Jr., Alan R. Sinaiko, Lydia A. Bazzano, Trudy L. Burns, Stephen R. Daniels, Terry Dwyer, Nina Hutri-Kähönen, Markus Juonala, Kari A. Murdy, Ronald J. Prineas, Olli T. Raitakari, Elaine M. Urbina, Alison Venn, Jessica G. Woo, Julia Steinberger
Objective: To examine childhood body mass index (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 Consortium. Data included childhood measurements (age 3-19) obtained during the 1970s-90s, 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 20-59 (mean 40.8) years, and 86% of them reported use of a confirmed anti-diabetic 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 incrementally increased risk of T2DM beginning at age 30, beginning at cut points below the 95th percentile for BMI and below 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.

Funding

This work was supported by the US National Institutes of Health (NIH; grant number R01 HL121230). Harmonization and other data work prior to obtaining NIH funding was supported by the Australian National Health and Medical Research Council Project (grant number APP1098369, APP211316), the Academy of Finland (grant numbers: 126925, 121584, 124282, 129378, 117787 and 41071), the Social Insurance Institution of Finland; Kuopio, Tampere, and Turku University Hospital Medical Funds, Juho Vainio Foundation, Paavo Nurmi Foundation, Finnish Foundation of Cardiovascular Research, Finnish Cultural Foundation, Sigrid Juselius Foundation, and Yrjö Jahnsson Foundation.

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