title: A cross-sectional study to determine the prevalence of obesity and other risk factors for type 2 diabetes among school children in Trinidad, West Indies.
abstract: BACKGROUND
  Our previous work has shown that type 2 diabetes mellitus is a problem in the school-aged population of Trinidad, West Indies. The current study evaluated the prevalence in this population of selected risk factors for diabetes, viz: obesity, family history of diabetes and acanthosis nigricans.
  
  
  OBJECTIVE
  To assess the prevalence of the following risk factors for type 2 diabetes (T2DM) in school children in Trinidad: obesity, family history of diabetes in first- or second-degree relatives and the presence of acanthosis nigricans (AN).
  
  
  METHODS
  A cross-sectional survey was performed among school children aged 7-18 years from September 2009 to June 2010. A convenience sample was selected from a random sample of 32 schools drawn from all educational districts. A self-administered questionnaire was employed to record family history, gender and ethnicity. AN was assessed and scored clinically at the neck and obesity was measured by anthropometry and bio-impedance.
  
  
  RESULTS
  There were 2130 participants in the study. Fifteen per cent were obese and 17% were overweight. Primary school children had a higher prevalence of obesity (22·9% vs 11·0%) and overweight (20·0% vs 15·6%) than secondary school children (P<0·05). A greater proportion of males than females had combined overweight/obesity as measured by BMI for age (35·8 vs 29·4%, P<0·05). The overall prevalence of AN was 43·4%. However, just over 18% of all school children have a degree of AN greater than grade 2, which clinically is readily recognisable. Females displayed this physical sign more commonly than males (P<0·05). The prevalences of a family history of diabetes in first- and second-degrees relatives were 11·0% and 1·1%, respectively. Forty-three per cent had one risk factor for diabetes, 23·1% had two and 2·9% had three.
  
  
  CONCLUSIONS
  Risk factors for T2DM are very common among school children in Trinidad. More than 40% had at least one risk factor. Strategies aimed at reducing risk factors for T2DM, especially obesity, among Trinidadian school children are urgently warranted.
authors.forename: Yvonne Ann
authors.initials: YA
authors.lastname: Batson
authors.forename: Surujpal
authors.initials: S
authors.lastname: Teelucksingh
authors.forename: Rohan G
authors.initials: RG
authors.lastname: Maharaj
authors.forename: Brian N
authors.initials: BN
authors.lastname: Cockburn
mesh_terms: D000052:Acanthosis Nigricans / Q000150:complications / Q000453:epidemiology*; D000293:Adolescent; D000886:Anthropometry; D002648:Child; D015510:Clinical Medicine / Q000379:methods; D003430:Cross-Sectional Studies; D003710:Demography; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology*; D005192:Family Health; D005260:Female; D006801:Humans; D008297:Male; D008487:Medical History Taking; D009765:Obesity / Q000150:complications / Q000453:epidemiology*; D015995:Prevalence; D011897:Random Allocation; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014300:Trinidad and Tobago / Q000453:epidemiology
keywords: Childhood,; Obesity; Risk factors,; Type 2 diabetes,