Obesity and Prediabetes are Jointly Associated with Lipid Abnormalities Among Adolescents: A Cross-Sectional Study
Received 4 November 2020
Accepted for publication 24 December 2020
Published 22 January 2021 Volume 2021:14 Pages 345—353
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Professor Ming-Hui Zou
Mohammad Almari,1,* Anwar Mohammad,2,* Jehad Abubaker,2 Ali H Ziyab3
1Department of Health Policy and Management, Faculty of Public Health, Kuwait University, Safat, Kuwait; 2Department of Biochemistry and Molecular Biology, Research Division, Dasman Diabetes Institute, Kuwait City, Kuwait; 3Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Safat, Kuwait
*These authors contributed equally to this work
Correspondence: Ali H Ziyab
Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Kuwait, P. O. Box 24923, Safat 13110, Kuwait
Purpose: Obesity and prediabetes are common among adolescents; however, it is unclear whether they jointly influence lipid levels. Hence, this study sought to assess whether obesity and prediabetes independently or jointly influence lipid levels among adolescents.
Methods: A cross-sectional study enrolled school students aged 14– 19 years (n = 1584). Body mass index (BMI)-for-age z-scores were estimated, and glycated hemoglobin A1c (HbA1c) and lipid profile were measured in capillary blood. Prediabetes was defined as 5.7≤ HbA1c% ≤ 6.4. Geometric means of lipids were calculated, and linear regression was used to estimate the ratio of geometric means (RoGM) and their 95% confidence intervals (CI). All analyses were stratified by sex.
Results: Of the total study participants, 52.1% (826/1584) were females and the majority were aged between 14.0 (5th percentile) and 18.0 (95th percentile) years. Based on BMI-for-age categories, 356 (22.5%) and 494 (31.2%) participants were classified as overweight and obese, respectively. Moreover, 34.3% (543/1584) of the study participants met the prediabetes definition. Compared to those with normal BMI and no prediabetes (reference category), participants classified as obese and having prediabetes had elevated levels of total cholesterol (TC; RoGM=1.09, 95% CI: 1.06– 1.13), low-density lipoprotein cholesterol (LDL-C; 1.21, 1.13– 1.29), non-high-density lipoprotein cholesterol (non-HDL-C; 1.20, 1.14– 1.26), and triglycerides (TG; 1.18, 1.09– 1.27) and reduced HDL-C (0.91, 0.88– 0.95) levels. Independent of prediabetes, obesity was associated with all the investigated lipids. Prediabetes alone was associated with reduced levels of LDL-C and increased levels of HDL-C only among females.
Conclusion: Obesity independently and in combination with prediabetes demonstrated unfavorable effects on lipids among male and female adolescents, whereas prediabetes independently influenced LDL-C and HDL-C favorably only among females.
Keywords: obesity, prediabetes, lipids, adolescents, Kuwait
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