title: Metabolic syndrome is common and persistent in youth-onset type 2 diabetes: Results from the TODAY clinical trial.
abstract: OBJECTIVE
  To examine the prevalence of metabolic syndrome (MetS) in youth-onset type 2 diabetes in the Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) study.
  
  
  METHODS
  Prevalence of MetS (ATP III definition) was compared at baseline (n = 679) and at 6 (n = 625) and 24 months (n = 545) using chi-square tests. Laboratory data were examined between MetS classifications at each time point using ANOVA.
  
  
  RESULTS
  Baseline prevalence of MetS was 75.8% and did not differ by treatment group or change over time. MetS was more common in females (83.1%) than males (62.3%; P < 0.0001) at baseline; this difference persisted over 24 months. Prevalence of MetS was similar between ethnic groups at baseline but greater in Hispanics (82.7%) vs. non-Hispanic Whites (67.5%; P = 0.0017) and non-Hispanic Blacks (72.7%; P = 0.0164) at 24 months. Although MetS was common in participants with hemoglobin A1c < 7.0% (74.4% at baseline; no significant change over 24 months), it was more common in those who did not maintain glycemic control at 6 months (80.3%; P = 0.0081). Elevated C-reactive protein, ALT, IL-6, and PAI-1 levels were more frequent with MetS.
  
  
  CONCLUSIONS
  Persistent high prevalence of MetS in youth-onset diabetes, even with excellent glycemic control, is of concern given the associated increased cardiovascular risk.
authors.affiliation: Department of Medicine, SUNY Upstate Medical University, Syracuse, New York, USA.
authors.forename: Ruth S
authors.initials: RS
authors.lastname: Weinstock
authors.affiliation: Department of Epidemiology and Biostatistics, Biostatistics Center, George Washington University, Rockville, Maryland, USA.
authors.forename: Kimberly L
authors.initials: KL
authors.lastname: Drews
authors.affiliation: Department of Pediatrics, Yale University, New Haven, Connecticut, USA.
authors.forename: Sonia
authors.initials: S
authors.lastname: Caprio
authors.affiliation: Department of Pediatrics, Naomi Berrie Diabetes Center, Columbia University Medical Center, New York, New York, USA.
authors.forename: Natasha I
authors.initials: NI
authors.lastname: Leibel
authors.affiliation: Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA.
authors.forename: Siripoom Vudhipoom
authors.initials: SV
authors.lastname: McKay
authors.affiliation: Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
authors.forename: Philip S
authors.initials: PS
authors.lastname: Zeitler
mesh_terms: D000293:Adolescent; D001741:Black or African American; D044383:Black People; D001786:Blood Glucose / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000208:ethnology*; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D044465:White People; D055815:Young Adult
chemical_list: D001786:Blood Glucose