title: Impaired fasting glucose prevalence in two nationwide cohorts of obese children and adolescents.
abstract: OBJECTIVE
  Impaired fasting glucose (IFG), a pre-stage to type 2 diabetes in adults, is also present in obese children. A large variation of the occurrence has been recorded, but the true prevalence is unknown due to lack of larger representative cohort studies. This study was implemented to investigate the prevalence of IFG in two nationwide cohorts of obese children and to find factors that affect the risk of IFG.
  
  
  METHODS
  A cross-sectional study based on data collected from two nationwide registers of obese children in Germany and Sweden, respectively.
  
  
  METHODS
  Subjects included were 2-18 years old. 32,907 subjects with fasting glucose were eligible in Germany and 2726 in Sweden. Two cutoff limits for IFG were used: 5.6-6.9 mmol l(-1) according to the American Diabetes Association (ADA) and 6.1-6.9 mmol l(-1)according to the World Health Organization (WHO). Variables collected were gender, age and degree of obesity. Logistic regression was used to calculate odds ratios.
  
  
  RESULTS
  The total prevalence of IFG among obese children in the German cohort according to the ADA was 5.7% and according to the WHO it was 1.1%. In Sweden, the corresponding prevalence was 17.1% and 3.9%, respectively. IFG risk was correlated with increasing age, male sex and degree of obesity.
  
  
  CONCLUSIONS
  IFG is highly prevalent among obese children. Age and degree of obesity are positively correlated with the risk of having IFG. There are large regional differences. After adjustments, obese children in Sweden, due to unknown reasons, have a 3.4- to 3.7-fold higher risk of having IFG than obese children in Germany.
authors.affiliation: Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
authors.forename: E
authors.initials: E
authors.lastname: Hagman
authors.affiliation: Department of Pediatric Endocrinology, Diabetes, and Nutrition Medicine, University of Witten/Herdecke, Datteln, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Reinehr
authors.affiliation: Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
authors.forename: J
authors.initials: J
authors.lastname: Kowalski
authors.affiliation: Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Ekbom
authors.affiliation: Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
authors.forename: C
authors.initials: C
authors.lastname: Marcus
authors.affiliation: Institute of Epidemiology and Medical Biometry University of Ulm, Ulm, Germany.
authors.forename: R W
authors.initials: RW
authors.lastname: Holl
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000378:metabolism*; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D003324:Coronary Artery Disease / Q000097:blood / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000517:prevention & control*; D005215:Fasting; D005260:Female; D005858:Germany / Q000453:epidemiology; D018149:Glucose Intolerance / Q000097:blood* / Q000453:epidemiology; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D016015:Logistic Models; D008297:Male; D063766:Pediatric Obesity / Q000097:blood* / Q000453:epidemiology / Q000517:prevention & control; D011236:Prediabetic State / Q000097:blood* / Q000453:epidemiology; D011237:Predictive Value of Tests; D015995:Prevalence; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human