Characteristics of Adolescents and Youth with Recent-Onset Type 2 Diabetes: The TODAY Cohort at Baseline
Characteristics of Adolescents and Youth with Recent-Onset Type 2 Diabetes: The TODAY Cohort at Baseline
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DOI：
10.1210/jc.2010-1642
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发表时间：
2011-01-01
影响因子：
5.8
通讯作者：
Willi, Steven
中科院分区：
文献类型：
--
作者：
Copeland, Kenneth C.;Zeitler, Philip;Willi, Steven
背景：青少年和青年2型糖尿病的治疗选择（TODAY）队列代表了最近发病的美国青年2型糖尿病的最大和最具特征的国家样本。目的：本研究的目的是描述TODAY随机临床试验参与者的基线特征。设计：在美国15个临床中心招募参与者（n = 704），时间超过4年，纳入、随机化、治疗和随访2-6年。背景：研究在儿科糖尿病护理诊所和实践中进行。参与者：符合条件的参与者年龄为10-17岁，诊断为2型糖尿病少于2年，身体质量指数在第85百分位或更高。干预措施：基线数据收集后，参与者被随机分为以下组之一：1)单用二甲双胍，2)二甲双胍加罗格列酮，或3)二甲双胍加体重管理生活方式方案。主要结果测量：基线数据包括人口统计学、临床/病史、生化测量、临床和生化异常。结果：在基线时，队列包括以下内容：64.9%为女性；平均年龄14.0岁；平均糖尿病病程为7.8个月；平均体重指数Z-score为2.15；有糖尿病家族史的占89.4%；41.1%为西班牙裔，31.5%为非西班牙裔黑人；38.8%与亲生父母同住；41.5%的家庭年收入低于25,000美元；26.3%的父母/监护人的最高受教育程度低于高中学历；26.3%的人血压在第90百分位或更高；13.6%的人血压在第95百分位或更高；13.0%有微量白蛋白尿；79.8%的患者高密度脂蛋白水平较低；10.2%的人有高甘油三酯。结论：TODAY队列主要来自种族/少数民族群体，社会经济地位低，有糖尿病家族史。临床和生化异常及合并症在诊断后2年内普遍存在。这些发现极大地促进了我们对美国青少年2型糖尿病的了解。[J] .中华内分泌杂志，2011,25(3):559 - 567。
Context: The Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) cohort represents the largest and best-characterized national sample of American youth with recent-onset type 2 diabetes.Objective: The objective of the study was to describe the baseline characteristics of participants in the TODAY randomized clinical trial.Design: Participants were recruited over 4 yr at 15 clinical centers in the United States (n = 704) and enrolled, randomized, treated, and followed up 2-6 yr.Setting: The study was conducted at pediatric diabetes care clinics and practices.Participants: Eligible participants were aged 10-17 yr inclusive, diagnosed with type 2 diabetes for less than 2 yr and had a body mass index at the 85th percentile or greater.Interventions: After baseline data collection, participants were randomized to one of the folllowing groups: 1) metformin alone, 2) metformin plus rosiglitazone, or 3) metformin plus a lifestyle program of weight management.Main Outcome Measures: Baseline data presented include demographics, clinical/medical history, biochemical measurements, and clinical and biochemical abnormalities.Results: At baseline the cohort included the following: 64.9% were female; mean age was 14.0 yr; mean diabetes duration was 7.8 months; mean body mass index Z-score was 2.15; 89.4% had a family history of diabetes; 41.1% were Hispanic, 31.5% were non-Hispanic black; 38.8% were living with both biological parents; 41.5% had a household annual income of less than $25,000; 26.3% had a highest education level of parent/guardian less than a high school degree; 26.3% had a blood pressure at the 90th percentile or greater; 13.6% had a blood pressure at the 95th percentile or greater; 13.0% had microalbuminuria; 79.8% had a low high-density lipoprotein level; and 10.2% had high triglycerides.Conclusions: The TODAY cohort is predominantly from racial/ethnic minority groups, with low socio-economic status and a family history of diabetes. Clinical and biochemical abnormalities and comorbidities are prevalent within 2 yr of diagnosis. These findings contribute greatly to our understanding of American youth with type 2 diabetes. (J Clin Endocrinol Metab 96: 159-167, 2011)