Abstract：
OBJECTIVE: Guidelines recommend case finding for dysglycemia (prediabetes and type 2 diabetes [T2D]) in adults or youth older than 10 years with overweight/obesity, but increased adiposity has not been associated with dysglycemia in some Hispanic populations. This study aims to determine the prevalence of dysglycemia in this population using simplified criteria independent of body mass index and age to request an oral glucose tolerance test (OGTT).
METHODS: Cross-sectional retrospective analysis of medical records from a clinical center in Chile (2000-2007). OGTT was obtained from any patient with 1 cardiometabolic risk factor (CMRF) independent of age and body mass index.
RESULTS: In total, 4969 adults (mean age ± SD) 45.7 ± 15.9 years and 509 youths 16.6 ± 3.0 years were included. The prevalence (%, 95% CI) of prediabetes doubled that of T2D in youths (14.1%, 1.4-17.4 vs 6.3%, 4.5-8.7) and tripled it in adults (36.0%, 34.7-37.4 vs 10.7%, 9.8-11.5). In underweight and normal-weight adults, 22% (12.0-36.7) and 29.2% (26.4-32.1) had prediabetes, whereas 4.9% (1.3-16.1) and 8.8% (7.2-10.7) had T2D, respectively. In normal weight youths, 10.5% (6.7-15.9) and 2.9% (1.2-6.6) had prediabetes and T2D, respectively. In adults, but not in youths, most dysglycemia categories were related to overweight/obesity.
CONCLUSIONS: This study supports a public health policy to identify more people at risk for cardiovascular disease by implementing a revised case finding protocol for dysglycemia using OGTT in even normal weight patients over 6 years of age when there is at least 1 CMRF. Reanalysis of case finding protocols for cardiometabolic risk in other populations is warranted.
METHODS: Cross-sectional retrospective analysis of medical records from a clinical center in Chile (2000-2007). OGTT was obtained from any patient with 1 cardiometabolic risk factor (CMRF) independent of age and body mass index.
RESULTS: In total, 4969 adults (mean age ± SD) 45.7 ± 15.9 years and 509 youths 16.6 ± 3.0 years were included. The prevalence (%, 95% CI) of prediabetes doubled that of T2D in youths (14.1%, 1.4-17.4 vs 6.3%, 4.5-8.7) and tripled it in adults (36.0%, 34.7-37.4 vs 10.7%, 9.8-11.5). In underweight and normal-weight adults, 22% (12.0-36.7) and 29.2% (26.4-32.1) had prediabetes, whereas 4.9% (1.3-16.1) and 8.8% (7.2-10.7) had T2D, respectively. In normal weight youths, 10.5% (6.7-15.9) and 2.9% (1.2-6.6) had prediabetes and T2D, respectively. In adults, but not in youths, most dysglycemia categories were related to overweight/obesity.
CONCLUSIONS: This study supports a public health policy to identify more people at risk for cardiovascular disease by implementing a revised case finding protocol for dysglycemia using OGTT in even normal weight patients over 6 years of age when there is at least 1 CMRF. Reanalysis of case finding protocols for cardiometabolic risk in other populations is warranted.
摘要：
目标：指南推荐对10岁以上超重/肥胖的成年人或青少年的血糖异常（前驱糖尿病和2型糖尿病[T2D]）进行病例发现，但在某些西班牙裔人群中,肥胖增加与血糖异常无关.这项研究旨在使用与BMI和年龄无关的简化标准来确定该人群中血糖异常的患病率，以要求进行口服葡萄糖耐量测试（OGTT）。
方法：对智利一家临床中心（2000-2007）的病历进行横断面回顾性分析。OGTT来自任何具有一个心脏代谢危险因素（CMRF）的患者，与年龄和BMI无关。
结果：总计，包括4,969名成年人（平均年龄±SD）45.7±15.9岁和509名年轻人16.6±3.0岁。患病率(%,95CI）的糖尿病前期是青少年T2D的两倍（14.1%，1.4-17.4vs.6.3%,4.5-8.7），并在成年人中增加了两倍（36.0％，34.7-37.4vs.10.7%,9.8-11.5)。在体重不足和体重正常的成年人中，22%（12.0-36.7）和29.2%（26.4-32.1）患有糖尿病前期，4.9%(1.3-16.1)和8.8%(7.2-10.7)患有T2D，分别。在体重正常的年轻人中，10.5%（6.7-15.9）和2.9%（1.2-6.6）患有糖尿病前期和T2D，分别。在成年人中,但不是在年轻人，大多数血糖异常类别与超重/肥胖有关.
结论：这项研究支持一项公共卫生政策，通过在至少有一个CMRF的6岁以上体重正常的患者中使用OGTT实施经修订的血糖异常病例发现方案，来识别更多的心血管疾病风险人群。有必要对其他人群中心脏代谢风险的病例发现方案进行重新分析。
方法：对智利一家临床中心（2000-2007）的病历进行横断面回顾性分析。OGTT来自任何具有一个心脏代谢危险因素（CMRF）的患者，与年龄和BMI无关。
结果：总计，包括4,969名成年人（平均年龄±SD）45.7±15.9岁和509名年轻人16.6±3.0岁。患病率(%,95CI）的糖尿病前期是青少年T2D的两倍（14.1%，1.4-17.4vs.6.3%,4.5-8.7），并在成年人中增加了两倍（36.0％，34.7-37.4vs.10.7%,9.8-11.5)。在体重不足和体重正常的成年人中，22%（12.0-36.7）和29.2%（26.4-32.1）患有糖尿病前期，4.9%(1.3-16.1)和8.8%(7.2-10.7)患有T2D，分别。在体重正常的年轻人中，10.5%（6.7-15.9）和2.9%（1.2-6.6）患有糖尿病前期和T2D，分别。在成年人中,但不是在年轻人，大多数血糖异常类别与超重/肥胖有关.
结论：这项研究支持一项公共卫生政策，通过在至少有一个CMRF的6岁以上体重正常的患者中使用OGTT实施经修订的血糖异常病例发现方案，来识别更多的心血管疾病风险人群。有必要对其他人群中心脏代谢风险的病例发现方案进行重新分析。
