Published online December 1, 2006
PEDIATRICS Vol. 118 No. 6 December 2006, pp. 2603 (doi:10.1542/peds.2006-1161)
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LETTER TO THE EDITOR

Low Prevalence of Impaired Fasting Glucose in Obese Adolescents From Southern Europe

Anna Grandone, MD
Alessandra Amato, MD
Emanuele Miraglia del Giudice, MD
Laura Perrone, MD
Department of Pediatrics,
Seconda Università di Napoli,
80138 Napoli, Italy

To the Editor.—

We read with great interest the article by Williams et al,1 which revealed a very high prevalence (7%) of impaired fasting glucose (IFG) among US adolescents (data were from the 1999–2000 National Health and Nutrition Examination Survey). Moreover, patients with IFG had features of insulin resistance and cardiovascular risk factors. Among overweight subjects, the prevalence of IFG raised to 17.8%.

Quite surprisingly, our experience with obese adolescents is very different.

We examined 450 obese adolescents (245 girls) from southern Italy. Their mean BMI z score2 was 3.8 ± 1.6 (range: 2–8). Their mean age was 14.1 ± 1.6 years (range: 12–19 years). The prevalence of IFG was only 1.5% (4 girls and 3 boys). Moreover, in the 126 patients who underwent an oral glucose-tolerance test, the prevalence of impaired glucose tolerance (IGT) was 5% (4 girls and 3 boys). One patient with IGT had IFG.

Some observations arise from these data. In adolescents from southern Italy the prevalence of IFG is much lower than in American adolescents; this difference could be a result of dietary habits and/or a particular genetic background. This latter hypothesis has probably only a secondary role, because also among the non-Hispanic white American adolescents1 the prevalence of IFG remains very high (7%).

The American Diabetes Association identified people with prediabetes, defined as IGT or IFG, as a high-risk group for the development of diabetes.3 Therefore, although the prevalence of obesity in southern Europe,4 as in the United States, is increasing alarmingly, in the future decades the occurrence of type 2 diabetes and related cardiovascular risk factors will be probably lower among southern European adolescents.

It could be useful to recognize any protective factors that prevent obese Mediterranean adolescents from developing prediabetes.

FOOTNOTES

Statements appearing here are those of the writers and do not represent the offcial position of the American Academy of Pediatrics or its Committees. Comments on any topic, including the contents of PEDIATRICS, are invited from all members of the profession; those accepted for publication will not be subject to major editorial revision but generally must be no more than 400 words in length. The editors reserve the right to publish replies and may solicit responses from authors and others.

Please see www.pediatrics.org for instructions on submitting letters.

REFERENCES

  1. Williams DE, Cadwell BL, Cheng YJ, et al. Prevalence of impaired fasting glucose and its relationship with cardiovascular disease risk factors in US adolescents, 1999–2000. Pediatrics. 2005;116 :1122 –1126[Abstract/Free Full Text]
  2. Cole TJ. The LMS method for constructing normalized growth standards. Eur J Clin Nutr. 1990;44 :45 –60[ISI][Medline]
  3. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2004;27(suppl 1) :S5 –S10
  4. Tzotzas T, Krassas GE. Prevalence and trends of obesity in children and adults of south Europe. Pediatr Endocrinol Rev. 2004;1(suppl 3) :448 –454
PEDIATRICS (ISSN 1098-4275). ©2006 by the American Academy of Pediatrics




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