Prevalence of Diagnosed and Undiagnosed Type 2 Diabetes Mellitus Among US Adolescents: Results From the Continuous NHANES, 1999-2010
Prevalence of Diagnosed and Undiagnosed Type 2 Diabetes Mellitus Among US Adolescents: Results From the Continuous NHANES, 1999-2010
复制标题
DOI：
10.1093/aje/kwt088
复制
发表时间：
2013-10-01
影响因子：
5
通讯作者：
Desvarieux, Moise
中科院分区：
文献类型：
--
作者：
Demmer, Ryan T.;Zuk, Aleksandra M.;Desvarieux, Moise
据报道，青少年中2型糖尿病（T2DM）的患病率和发病率正在上升，但缺乏国家数据，特别是关于未确诊T2DM的数据。为了估计确诊和未确诊的2型糖尿病在美国青少年中的患病率，我们分析了11,888名年龄为1219岁的青少年的全国代表性横断面，这些青少年在1999 - 2010年期间接受了全国连续健康和营养检查调查中的糖尿病访谈。其中，随机抽取4661名青少年的空腹血液样本。既往有糖尿病诊断且未服用药物或口服降糖药（含或不含胰岛素）的患者被归类为T2DM；报告单独使用胰岛素的人被归类为1型糖尿病。未确诊的糖尿病定义为空腹血糖浓度为126 mg/dL，并假定为2型糖尿病。在禁食亚样本中，确定了31例糖尿病病例（1型和2型），患病率为0.84（加权95可信区间（CI）： 0.51, 1.40）（276,638例；95 CI: 134,255, 419,020）。1型和2型糖尿病的患病率分别为0.48 （95 CI: 0.23, 1.02）和0.36 (95 CI: 0.20, 0.67)，表明T2DM占所有病例的43。此外，未确诊的T2DM患病率为0.12 (95 CI: 0.05, 0.31)，代表了34例T2DM病例（40,611例；95 CI: 2,850, 78,373）。2型糖尿病约占美国青少年糖尿病的一半，其中三分之一的病例未被诊断。
Although prevalence and incidence of type 2 diabetes mellitus (T2DM) are reportedly increasing among adolescents, national data are lacking, particularly in regard to undiagnosed T2DM. To estimate the prevalence of diagnosed and undiagnosed T2DM among US adolescents, we analyzed a nationally representative cross-section of 11,888 adolescents aged 1219 years who received a diabetes interview in the Continuous National Health and Nutrition Examination Survey during 19992010. Among them, a random subsample of 4,661 adolescents also had fasting blood samples collected. Persons who reported a previous diabetes diagnosis and were either taking no medication or taking an oral hypoglycemic agent (with or without insulin) were classified as having T2DM; persons who reported using insulin alone were classified as having type 1 diabetes. Undiagnosed diabetes was defined as a fasting plasma glucose concentration of 126 mg/dL and was assumed to be type 2. In the fasting subsample, 31 diabetes cases (types 1 and 2) were identified, representing a prevalence of 0.84 (weighted 95 confidence interval (CI): 0.51, 1.40) (276,638 cases; 95 CI: 134,255, 419,020). Estimates of the prevalences of type 1 and type 2 diabetes were 0.48 (95 CI: 0.23, 1.02) and 0.36 (95 CI: 0.20, 0.67), respectively, indicating that T2DM accounted for 43 of all cases. Further, undiagnosed T2DM prevalence was 0.12 (95 CI: 0.05, 0.31), representing 34 of T2DM cases (40,611 cases; 95 CI: 2,850, 78,373). T2DM accounts for approximately half of adolescent diabetes in the United States, and one-third of these cases are undiagnosed.