Correlates of Type 2 diabetes mellitus in children, adolescents and young adults in north India: a multisite collaborative case-control study.
OBJECTIVE
In this study we describe the clinical, anthropometric and biochemical characteristics of patients with early onset Type 2 diabetes mellitus (T2DM) (< 30 years of age) and compare them with healthy, non-diabetic individuals.


METHODS
In this multisite collaborative study, 51 patients with T2DM (40 male, 11 female) and 69 non-diabetic individuals of similar age and gender distribution (controls) as the cases (46 male and 23 female) were investigated. The following parameters were measured; anthropometry [body mass index (BMI), waist circumference, waist-hip ratio (WHR) and skin-fold thickness at four sites], percentage body fat (%BF) and lipid profile.


RESULTS
The mean (SD) age of diagnosis of T2DM was 21.4 (6.1) years. A significantly higher number of cases had a history of T2DM in first-degree relatives as compared with controls (82.3 vs. 23.2%, P < 0.001). The mean values and the prevalence of abnormal values of measures of generalized obesity (BMI and %BF) and abdominal obesity (waist circumference and WHR) were significantly higher in cases as compared with controls. Hypertriglyceridaemia [OR (95% CI): 4.6 (1.1-20.0)], high WHR [7.9 (2.5-24.4)] and family history of T2DM [7.3 (2.3-23.0)] were independently associated with T2DM. Age and gender adjusted odds ratios of T2DM were 23.3 (5.2-103.6), 37.7 (9.0-158.5) and 86.4 (17.0-438.5), respectively, with the following set of risk factors; hypertriglyceridaemia and high WHR, hypertriglyceridaemia and family history of T2DM, and high WHR and family history of T2DM. Finally, the presence of all three risk factors increased the odds of T2DM to 112.1 (10.8-1164.7).


CONCLUSIONS
Early identification of the simple clinical, anthropometric and biochemical parameters which are strongly associated with early onset T2DM in young Asian Indians may be useful for primary prevention.
Department of Internal Medicine, All India Institute of Medical Sciences, New Delhi, India.
N K
NK
Vikram
N
N
Tandon
A
A
Misra
M C
MC
Srivastava
R M
RM
Pandey
A
A
Mithal
S
S
Sharma
A
A
Ajmani
S V
SV
Madhu
C M
CM
Batra
N
N
Gupta
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D001794:Blood Pressure / Q000502:physiology; D015992:Body Mass Index; D016022:Case-Control Studies; D002648:Child; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000453:epidemiology* / Q000378:metabolism; D005192:Family Health; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008055:Lipids / Q000097:blood; D008297:Male; D009765:Obesity / Q000150:complications / Q000453:epidemiology; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood; D049629:Waist-Hip Ratio
D008055:Lipids; D014280:Triglycerides