青少年糖尿病查指南的预测能力
Sarah M Halvorson-Fried1,2, Nita Vangeepuram3,4,5, Negar Golestani6
1Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai.
medRxiv : the preprint server for health sciences
|December 17, 2025
概括
美国糖尿病协会 (ADA) 调整的查指南显示,在识别有早期发病2型糖尿病 (EOD) 和糖尿病前期 (preDM/EOD) 风险的青少年方面,敏感度较低. 为了有效的青少年糖尿病预防干预,需要改进查工具.
科学领域:
- 公共卫生 公共卫生
- 内分泌学 在内分泌学.
- 青少年医学 青少年医学
背景情况:
- 早期发病的2型糖尿病 (EOD) 是一个越来越令人担忧的问题,在45岁之前被诊断出来.
- 青春期是建立健康行为和与预防糖尿病相关的生物过程的关键窗口.
- 目前针对成人糖尿病前期 (preDM) 和EOD的查工具并不适用于青少年,这凸显了青少年早期识别方面的差距.
研究的目的:
- 评估美国糖尿病协会 (ADA) 调整的查指南在预测青少年成人糖尿病前期 (preDM) 和2型糖尿病早期发病 (EOD) 的有效性.
- 评估这些调整后的指导方针在识别那些可能受益于早期干预的有风险的年轻人的表现.
主要方法:
- 利用了从青少年到成人健康 (添加健康) 国家纵向研究的数据.
- 将修改后的ADA查指南应用于青少年数据 (波I和波II,年龄12-19岁).
- 通过使用生物标志物数据,评估了成年期前DM/EOD的预测 (第4波和第5波,年龄24-43岁).
主要成果:
- 40%的参与者在成年后出现了前DM/前EOD.
- 经过调整的ADA指南仅确定了23.6%的患有前DM/EOD (低敏感性) 的人.
- 该指南显示高特异性 (88.6%),但具有较低的积极预测值 (57.8%) 和负预测值 (63.7%).
结论:
- 适应的ADA查指南显示,在识别有发展前DM/EOD风险的青少年时,预测能力较差.
- 显著大多数 (76%) 患有前DM/EOD的青少年没有根据适应的查标准进行标记.
- 发展更有效的查工具至关重要,以识别有风险的年轻人,以便针对性地预防糖尿病.
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