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Cardiometabolic risk factors, metabolic syndrome and pre-diabetes in adolescents in the Sierra region of Ecuador

Abstract:

Background: Excess weight (overweight and obesity) is the major modifiable risk factor for type 2 diabetes mellitus (T2DM) and other non-communicable diseases. However, excess weight may not be as pbkp_redictive of diabetes risk as once thought. While excess weight and other obesity-related non-communicable diseases are of growing concern in low-middle income countries in Latin America, there is limited research on risk factors associated with T2DM in adolescents. This study investigated prevalence of overweight, obesity, pbkp_rediabetes, diabetes and metabolic syndrome in adolescents in Ecuador. Methods: A cross-sectional study was conducted with 433 adolescents from two schools in a small urban center in southern Ecuador and two schools in a large urban center in Quito. Risk factors were measured, including: height, weight, BMI, waist-to-hip ratio, fasting glucose, lipid panel, and HbA1c. Multivariate analysis of variance (MANOVA) was separately applied to risk factors and demographic factors as a set of dependent variables with sex, location and their interaction included as pbkp_redictors. An independent t test was run on the data at 95% confidence intervals for the mean difference. The values for the triglycerides, LDL and VLDL were positively skewed. A Mann-Whitney U test was run on these data. Results: Using IOTF standards, 9.8% were overweight and 1.9% were obese. Only 1.6% of the sample met the criteria for pbkp_rediabetes by fasting glucose but 12.4% of the sample met the criteria for pbkp_rediabetes by HbA1c. None of the participants met criteria for diabetes. There were 2.3% of the participants that met the IDF criteria for metabolic syndrome. Adolescents from the larger urban center had higher rates of pbkp_rediabetes, higher mean HbA1c, blood pressure, lipid values, and lower HDL levels. Conclusions: Use of HbA1c identified more adolescents with pbkp_rediabetes than FBG. The HbA1c measure is an attractive screening tool for pbkp_rediabetes in developing countries. Although rates of obesity in Ecuadorian adolescents are low there is significant evidence to suggest that pbkp_rediabetes is permeating the smaller urban centers. Traditional screening tools may underestimate this risk.