Prevalence and predictors of prediabetes/type 2 diabetes mellitus among adolescents in the United States: NHANES (2021-2023).
Level 4 - case-series / case-control
Cross-sectional survey analysis
PubMed 41739753 · doi:10.1371/journal.pgph.0005596
What was done
Authors analyzed cross-sectional data from 1,998 adolescents aged 10-19 years in the United States using the National Health and Nutrition Examination Survey (NHANES 2021-2023). Prediabetes or type 2 diabetes mellitus was defined as hemoglobin A1c >= 5.7% or fasting plasma glucose >= 100 mg/dL. Unweighted univariate and multiple logistic regression models were used to identify demographic and cardiometabolic predictors.
What was found
Overall, 30.8% of adolescents had prediabetes or type 2 diabetes. In multiple logistic regression, significant independent predictors were older age (AOR = 0.91, p = 0.025), female gender (AOR = 0.52, p = 0.002), and elevated waist-to-height ratio (AOR = 146.19, p = 0.0004). In univariate analysis, significant associations were also reported for overweight/obesity (OR = 1.57, p = 0.012), daily sugar intake (OR = 1.003, p = 0.042), low HDL cholesterol <= 45 mg/dL (OR = 1.41, p = 0.032), systolic blood pressure (OR = 1.02, p = 0.002), and diastolic blood pressure (OR = 1.02, p = 0.037).
Why it matters
This study indicates that nearly one in three US adolescents meets criteria for dysglycemia, with central adiposity (waist-to-height ratio) emerging as a far stronger predictor than general BMI-based overweight or obesity.
Limits
The cross-sectional design precludes establishing causality or temporality. The analysis used unweighted regression models, limiting national representativeness despite using NHANES data. Prediabetes and type 2 diabetes were combined rather than analyzed separately, and confidence intervals are not reported in the abstract.
Cited by
- supports One in four teenagers in the United States has prediabetes or type 2 diabetes.