title: Lack of racial disparity in incident prediabetes and glycemic progression among black and white offspring of parents with type 2 diabetes: the pathobiology of prediabetes in a biracial cohort (POP-ABC) study.
abstract: BACKGROUND
  Although the incidence of type 2 diabetes (T2D) among persons with prediabetes is well known (∼10%/y), the incidence of prediabetes among normoglycemic persons is unclear. Also, in the Diabetes Prevention Program, no racial/ethnic differences were seen in diabetes incidence, whereas marked racial/ethnic disparities are reported in the prevalence of T2D. We aimed to obtain estimates of incident prediabetes and determine whether racial disparities manifest during transition to prediabetes.
  
  
  METHODS
  We enrolled 376 (217 black, 159 white) nondiabetic offspring of parents with T2D (mean age 44.2 y) and followed them up quarterly for 5.5 years. Assessments included anthropometry, body composition, oral glucose tolerance test, biochemistries, energy expenditure, insulin sensitivity, and insulin secretion. The primary outcome was progression to impaired fasting glucose and/or impaired glucose tolerance (or diabetes).
  
  
  RESULTS
  Of 343 participants with evaluable data, 101 subjects (49 white, 52 black) developed prediabetes, and 10 (4 white, 6 black) developed diabetes during a mean follow-up of 2.62 years. There was no significant racial difference in the cumulative incidence of prediabetes (32.7% white, 30% black) or combined prediabetes/diabetes (35% white, 30% black). Significant predictors of prediabetes included age, gender, trunk fat, 2-hour postload glucose (2hrPG), insulin sensitivity, and insulin secretion. In a Cox proportional-hazards model, with adjustment for age and sex, the 2hrPG and abdominal obesity were independent predictors of incident prediabetes/diabetes [relative hazards (95% confidence interval [CI]) for the 90th vs 10th percentile: trunk fat mass 2.90 (95% CI 1.74-4.82), P < .0001; 2hrPG 2.54 (95% CI 1.46-4.40), P = .0009]. Having the trunk fat mass and the 2hrPG at the 90th percentile conferred a 7-fold hazard of prediabetes compared with persons at the 10th percentile for both measures.
  
  
  CONCLUSIONS
  Black and white offspring of parents with type 2 diabetes develop prediabetes at a similar high rate of approximately 11% per year. Therefore, close surveillance, with prompt intervention to prevent dysglycemia, is warranted in persons with parental diabetes.
authors.affiliation: Department of Medicine (S.D.-J., C.E., S.E., E.N.), Division of Endocrinology, Diabetes and Metabolism, General Clinical Research Center (S.D.-J.), and Department of Preventive Medicine (J.W.), University of Tennessee Health Science Center, Memphis, Tennessee 38163.
authors.forename: Samuel
authors.initials: S
authors.lastname: Dagogo-Jack
authors.forename: Chimaroke
authors.initials: C
authors.lastname: Edeoga
authors.forename: Sotonte
authors.initials: S
authors.lastname: Ebenibo
authors.forename: Ebenezer
authors.initials: E
authors.lastname: Nyenwe
authors.forename: Jim
authors.initials: J
authors.lastname: Wan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D044383:Black People / Q000706:statistics & numerical data*; D001786:Blood Glucose / Q000378:metabolism*; D016241:Child of Impaired Parents / Q000706:statistics & numerical data*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D018450:Disease Progression; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011236:Prediabetic State / Q000453:epidemiology / Q000208:ethnology*; D044465:White People / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D001786:Blood Glucose