title: Progression from impaired glucose tolerance to type 2 diabetes in obese children and adolescents: a 3-6-year cohort study in southern Thailand.
abstract: BACKGROUND
  Childhood obesity is associated with abnormal glucose metabolism and type 2 diabetes mellitus (T2DM). This study evaluated the prevalence of abnormal glucose metabolism in asymptomatic obese children and adolescents, and determined the percentage of T2DM development after 3-6 years of follow-up.
  
  
  METHODS
  During 2007-2013, 177 obese children and adolescents who had normal fasting plasma glucose (FPG<100 mg/dL) were given an oral glucose tolerance test (OGTT). The participants were classified into four groups: normal glucose tolerance (NGT), NGT-hyperinsulinemia (NGT-HI), impaired glucose tolerance (IGT), and diabetes mellitus (DM). Blood chemistries, including FPG, glycated hemoglobin, and lipid profiles, and liver function test were performed every 6-12 months or when the patient developed any symptom or sign indicative of diabetes.
  
  
  RESULTS
  Glucose metabolism alterations were detected in 81.4% of the participants: 63.8% with NGT-HI, 15.3% with IGT, and 2.3% with T2DM. The median levels of homeostasis model assessment-insulin resistance (HOMA-IR) in patients with IGT (8.63) were significantly greater than those in the patients with NGT (4.04) (p<0.01). During the follow-up, 22 patients (14.4%) developed T2DM significantly more from the IGT group (nine of 33 cases, 27.3%) than the NGT-HI group (12 of 108 cases, 11.1%) (p=0.022). The predicting parameters for T2DM conversion were weight status, body mass index (BMI), FBG, fasting insulin, alanine transaminase (ALT) levels, and HOMA-IR.
  
  
  CONCLUSIONS
  Glucose metabolism alteration was commonly found among obese adolescents. Factors associated with T2DM development were greater weight status and the severity of insulin resistance as shown by higher HOMA-IR levels.
authors.forename: Somchit
authors.initials: S
authors.lastname: Jaruratanasirikul
authors.forename: Sudarat
authors.initials: S
authors.lastname: Thammaratchuchai
authors.forename: Maneerat
authors.initials: M
authors.lastname: Puwanant
authors.forename: Ladda
authors.initials: L
authors.lastname: Mo-Suwan
authors.forename: Hutcha
authors.initials: H
authors.lastname: Sriplung
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D002648:Child; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology*; D018450:Disease Progression; D005260:Female; D018149:Glucose Intolerance / Q000150:complications / Q000208:ethnology / Q000378:metabolism / Q000503:physiopathology*; D019456:Health Transition; D006801:Humans; D006946:Hyperinsulinism / Q000150:complications / Q000208:ethnology / Q000378:metabolism / Q000503:physiopathology*; D007333:Insulin Resistance / Q000208:ethnology; D008137:Longitudinal Studies; D008297:Male; D050177:Overweight / Q000097:blood / Q000150:complications* / Q000208:ethnology; D063766:Pediatric Obesity / Q000097:blood / Q000150:complications* / Q000208:ethnology; D011236:Prediabetic State / Q000150:complications / Q000208:ethnology / Q000378:metabolism / Q000503:physiopathology*; D015995:Prevalence; D012372:ROC Curve; D012306:Risk; D013785:Thailand / Q000453:epidemiology
chemical_list: D015415:Biomarkers