Determinants of fasting glucose in young Guatemalan adults.
OBJECTIVE
To examine correlates of fasting glucose, a precursor for type 2 diabetes mellitus, in young adults in Guatemala, a country undergoing an epidemiologic transition.


METHODS
Cross-sectional.


METHODS
Anthropometric, lifestyle, dietary, serum lipid, and socioeconomic characteristic data were collected on 189 men and 201 women (mean age 24.4 years) born in four villages in Eastern Guatemala. We used linear regression to identify parsimonious predictive models, including 2-way interactions.


RESULTS
In men, mean fasting glucose was 87.3 mg/dL (SD 10.2); our model explained 30% of variance. Body mass index (BMI), abdomen-to-hip ratio (AHR), and total cholesterol showed graded positive effects. BMI and AHR interacted (P<.001); men with high BMI and high AHR had the highest fasting glucose levels. No dietary factors independently predicted fasting glucose. In women, mean fasting glucose was 83.9 mg/dL (SD 8.5); 22% of variance was explained by BMI, energy-adjusted fat intake, physical activity, birth village, and current residence (rural/urban). BMI and fasting glucose were positively related. Urban residence interacted with birth village (P=.06) and physical activity (P=.13).


CONCLUSIONS
The major conclusion drawn from this study is that increased adiposity, even among lean individuals, is the largest environmental predictor of fasting glucose. Prevention and control of obesity in young adults in transitioning countries are key strategies for the prevention of diabetes.
Conlisk
A J
AJ
Department of International Health, Rollins School of Public Health Atlanta, GA 30322, USA. aconlis@emory.edu
Stein
A D
AD
Schroeder
D G
DG
Torun
B
B
Grajeda
R
R
Martorell
R
R
D000328:Adult; D000886:Anthropometry; D001786:Blood Glucose / Q000032:analysis*; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000453:epidemiology / Q000209:etiology; D004032:Diet; D004467:Economics; D005215:Fasting / Q000097:blood*; D005260:Female; D018149:Glucose Intolerance / Q000097:blood / Q000208:ethnology; D006166:Guatemala / Q000453:epidemiology; D006801:Humans; D008019:Life Style; D008297:Male; D015233:Models, Statistical; D009765:Obesity / Q000150:complications / Q000453:epidemiology; D012307:Risk Factors
D001786:Blood Glucose; D008076:Cholesterol, HDL; D002784:Cholesterol