title: Examining trends in prediabetes and its relationship with the metabolic syndrome in US adolescents, 1999-2014.
abstract: OBJECTIVE
  We sought to investigate temporal trends in prediabetes prevalence among US adolescents using two definitions and evaluate relationships with obesity and a MetS-severity score.
  
  
  METHODS
  We evaluated data from 5418 non-Hispanic white, non-Hispanic black, and Hispanic adolescents aged 12-19 participating in the National Health and Nutrition Examination Survey 1999-2014 with complete data regarding MetS and hemoglobin A1c (HbA1c). Prediabetes status was defined by American Diabetes Association (ADA) criteria: fasting glucose 100-125 mg/dL or HbA1c 5.7%-6.4%. MetS severity was assessed with a MetS-severity Z-score.
  
  
  RESULTS
  Prevalence of prediabetes as defined by HbA1c abnormalities significantly increased from 1999-2014, while prevalence of prediabetes as defined by fasting glucose abnormalities showed no significant temporal trend. There were variations in these trends across different racial/ethnic groups. MetS Z-score was overall more strongly correlated with HbA1c, fasting insulin, and the homeostasis model of insulin resistance than was BMI Z-score. These correlations were true in each racial/ethnic group with the exception that in non-Hispanic white adolescents, in whom the MetS Z-score was not significantly correlated with HbA1c measurements.
  
  
  CONCLUSIONS
  We found conflicting findings of temporal trends of US adolescent prediabetes prevalence based on the ADA's prediabetes criteria. The increasing prevalence of prediabetes by HbA1c assessment is concerning and raises the urgency for increased awareness and appropriate measures of prediabetes status among physicians and patients.
authors.affiliation: Department of Pediatrics, University of Virginia, Charlottesville, VA, 22908, USA.
authors.forename: Arthur M
authors.initials: AM
authors.lastname: Lee
authors.affiliation: Department of Pediatrics, University of Virginia, Charlottesville, VA, 22908, USA.
authors.forename: Cyrelle R
authors.initials: CR
authors.lastname: Fermin
authors.affiliation: Department of Health Outcomes and Policy, College of Medicine, University of Florida, Gainesville, FL, 32608, USA.
authors.forename: Stephanie L
authors.initials: SL
authors.lastname: Filipp
authors.affiliation: Department of Health Outcomes and Policy, College of Medicine, University of Florida, Gainesville, FL, 32608, USA.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Gurka
authors.affiliation: Department of Pediatrics, University of Virginia, Charlottesville, VA, 22908, USA. deboer@virginia.edu.
authors.forename: Mark D
authors.initials: MD
authors.lastname: DeBoer
mesh_terms: D000293:Adolescent; D001741:Black or African American / Q000706:statistics & numerical data; D002648:Child; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000453:epidemiology*; D009749:Nutrition Surveys; D009765:Obesity / Q000150:complications / Q000453:epidemiology; D011236:Prediabetic State / Q000150:complications / Q000453:epidemiology*; D015995:Prevalence; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D006442:Glycated Hemoglobin
keywords: Insulin resistance; Metabolic syndrome; Obesity; Prediabetes; Type 2 diabetes mellitus