Adolescent metabolic syndrome and its components associations with incidence of type 2 diabetes in early adulthood: Tehran lipid and glucose study

AIM: To investigate the association of youth metabolic syndrome (MetS) and its components, individually and in combination with early adulthood incident type 2 diabetes (T2DM). METHODS: A total of 2798 adolescents aged 11–19 years enrolled in the study. At baseline, MetS, its components including blood pressure (BP), waist circumference (WC), triglycerides (TGs), fasting plasma glucose, and low HDL-C, and different combinations of MetS components were defined. After a mean 11.3 years of follow-up, T2DM was determined. Multivariable Cox proportional hazard regression analysis adjusted for age, sex, family history of T2DM, and adult BMI was used for data analysis. The hazard ratio (HR) and 95% confidence interval (CI) were reported. RESULTS: During the follow-up, 44 incidents T2DM were developed. Among different individual components, only high WC [HR = 2.63, 95% CI (1.39–4.97)] and high TGs [HR = 1.82, 95% CI (1.00–3.34)] remained as significant predictors only in the age and sex adjusted model. Regarding combinations of MetS components, ‘high TGs and high WC’ [HR = 2.70, 95% CI (1.27–5.77)], ‘high BP and high WC’ [HR = 2.52, 95% CI (1.00–6.33)], ‘high TGs and high BP’ [HR = 2.27, 95% CI (1.02–5.05)] as well as MetS per se [HR = 2.82, 95% CI (1.41–5.64)] had a significant relationship with incident T2DM in the multivariable adjusted model. Among different confounders, being female and having family history of T2DM were consistently associated with higher risk of T2DM, in different combinations of MetS components. CONCLUSIONS: Adolescence MetS and some combinations of MetS components predicted early adulthood T2DM. Thus, adolescents, particularly female ones, with combinations of MetS components as well as those with family history of T2DM could be targeted for lifestyle intervention.