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Obesity and Type 2 Diabetes Mellitus in Children and Adolescents in Shantou City: A Population-based Study

Author: ZhengYuBin
Tutor: ChenShenRen
School: Shantou University
Course: Internal Medicine
Keywords: Children Adolescents Obesity Type 2 Diabetes Mellitus Epidemiology
CLC: R589.2
Type: Master's thesis
Year: 2011
Downloads: 60
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Abstract

Objectives:To determine the prevalence and risk factors of obesity and type 2 diabetes mellitus (T2DM) in children and adolescents in Shantou City.Methods:A population-based cross-sectional study was con-ducted in Shantou, 3 primary and middle schools were selected by a stratified cluster random sampling in Shantou, with a total of 5662 students aged 6 to 18 years. Weight and height were measured and the body mass index (BMI) was calculated in all the participants. In children and adolescents at high risk for T2DM, blood specimens were collected for fasting plasma glucose (FPG), 2-hour postload glucose (2hPG), fasting insulin (FINS), 2-hour postload insulin (2hINS), glutamic acid decarboxylase autoantibodies (GAD-Ab), serum beta-microglobulin (Serumβ-MG), serum cystatin C (CysC), cholesterol (CH), triglycerides (TG), low-density lipoprotein (LDL), high density lipoprotein (HDL) and the insulin resistance index (HOMA-IR) was calculated. The Obesity diagnostic standard was based on BMI criterion of Centers for Disease Control Prevention (CDC) and the T2DM diagnostic standard was based on the criterion recommended by World Health Organization. Furthermore a self-assessment matching questionnaire on high risk factors of obesity and T2DM was carried out in 972 students with their parents. Results:The overall prevalence rates of overweight and obesity were 6.39% and 2.83% re-spectively. The rate of overweight was 8.23% for boys and 4.59% for girls (Chi-Square test,P=0.000), while the rate of obesity was 3.58% for boys and 2.10% for girls (Chi-Square test,P=0.000), reaching to the highest rate 2.4% and 1.2% respectively between 10 to 12 years old. The prevalence of T2DM, impaired fasting glucose, impaired glucose tolerance or metabolic syndrome was all 35.32/100 000, but there was no significant difference in age and gender. The HOMA-IR in blood glucose disorder group was higher than that in normal glucose tolerance group. But no remarkable difference was found in hypertension group, dyslipidemia group and renal damage group. The remarkable risk factors of obesity and T2DM were including the family history of obesity and T2DM, insulin resistance and its phenotype (e.g. acanthosis nigricans). The prevalence of obesity and T2DM was significantly associated with family education, dietary and physical activity, the knowledge and attitude to the obesity and T2DM of parents and students.Conclusions:Obesity and T2DM have been prevalent in children and adolescents in Shantou City. The pathogenic basis (insulin resistance) and clinical process of T2DM in children and adolescents were similar to that in adult, and both were usually occult in onset. Enhancing the knowledge on obesity and T2DM of parents and students, establishing an effective family education, fully acquainted with the risk factors of obesity and T2DM, and carrying out a purposeful control of reversible risk factors can effectively reduce or delay the onset and development of obesity and T2DM, and improve the life quality in children and adolescent.

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