Characteristics of Adolescents and Youth with Recent-Onset Type 2 Diabetes: The TODAY Cohort at Baseline

被引:324
作者
Copeland, Kenneth C. [1 ]
Zeitler, Philip [2 ]
Geffner, Mitchell [3 ]
Guandalini, Cindy [4 ]
Higgins, Janine [2 ]
Hirst, Kathryn [5 ]
Kaufman, Francine R. [3 ]
Linder, Barbara [6 ]
Marcovina, Santica [7 ]
McGuigan, Paul [8 ]
Pyle, Laura [5 ]
Tamborlane, William [4 ]
Willi, Steven [9 ]
机构
[1] Univ Oklahoma, Coll Med, Dept Pediat, Oklahoma City, OK 73104 USA
[2] Univ Colorado Denver, Dept Pediat, Aurora, CO 80045 USA
[3] Univ So Calif, Childrens Hosp Los Angeles, Keck Sch Med, Dept Pediat, Los Angeles, CA 90027 USA
[4] Yale Univ, Dept Pediat, New Haven, CT 06520 USA
[5] George Washington Univ, Ctr Biostat, Rockville, MD 20852 USA
[6] NIDDKD, NIH, Bethesda, MD 20892 USA
[7] Univ Washington, NW Lipid Metab & Diabet Res Labs, Seattle, WA 98109 USA
[8] Case Western Reserve Univ, Dept Pediat, Cleveland, OH 44106 USA
[9] Univ Penn, Childrens Hosp Philadelphia, Dept Endocrinol & Diabet, Philadelphia, PA 19104 USA
基金
美国国家卫生研究院;
关键词
FATTY LIVER; PREVALENCE; MELLITUS; CHILDREN; ASSOCIATION; AMERICAN; COMPLICATIONS; SEARCH;
D O I
10.1210/jc.2010-1642
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Context: The Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) cohort represents the largest and best-characterized national sample of American youth with recent-onset type 2 diabetes. Objective: The objective of the study was to describe the baseline characteristics of participants in the TODAY randomized clinical trial. Design: Participants were recruited over 4 yr at 15 clinical centers in the United States (n = 704) and enrolled, randomized, treated, and followed up 2-6 yr. Setting: The study was conducted at pediatric diabetes care clinics and practices. Participants: Eligible participants were aged 10-17 yr inclusive, diagnosed with type 2 diabetes for less than 2 yr and had a body mass index at the 85th percentile or greater. Interventions: After baseline data collection, participants were randomized to one of the folllowing groups: 1) metformin alone, 2) metformin plus rosiglitazone, or 3) metformin plus a lifestyle program of weight management. Main Outcome Measures: Baseline data presented include demographics, clinical/medical history, biochemical measurements, and clinical and biochemical abnormalities. Results: At baseline the cohort included the following: 64.9% were female; mean age was 14.0 yr; mean diabetes duration was 7.8 months; mean body mass index Z-score was 2.15; 89.4% had a family history of diabetes; 41.1% were Hispanic, 31.5% were non-Hispanic black; 38.8% were living with both biological parents; 41.5% had a household annual income of less than $25,000; 26.3% had a highest education level of parent/guardian less than a high school degree; 26.3% had a blood pressure at the 90th percentile or greater; 13.6% had a blood pressure at the 95th percentile or greater; 13.0% had microalbuminuria; 79.8% had a low high-density lipoprotein level; and 10.2% had high triglycerides. Conclusions: The TODAY cohort is predominantly from racial/ethnic minority groups, with low socio-economic status and a family history of diabetes. Clinical and biochemical abnormalities and comorbidities are prevalent within 2 yr of diagnosis. These findings contribute greatly to our understanding of American youth with type 2 diabetes. (J Clin Endocrinol Metab 96: 159-167, 2011)
引用
收藏
页码:159 / 167
页数:9
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