Metabolic syndrome is common and persistent in youth-onset type 2 diabetes: Results from the TODAY clinical trial

ObjectiveTo examine the prevalence of metabolic syndrome (MetS) in youth-onset type 2 diabetes in the Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) study. MethodsPrevalence of MetS (ATP III definition) was compared at baseline (n=679) and at 6 (n=625) and 24 months (n=545) using chi-square tests. Laboratory data were examined between MetS classifications at each time point using ANOVA. ResultsBaseline prevalence of MetS was 75.8% and did not differ by treatment group or change over time. MetS was more common in females (83.1%) than males (62.3%; P<0.0001) at baseline; this difference persisted over 24 months. Prevalence of MetS was similar between ethnic groups at baseline but greater in Hispanics (82.7%) vs. non-Hispanic Whites (67.5%; P=0.0017) and non-Hispanic Blacks (72.7%; P=0.0164) at 24 months. Although MetS was common in participants with hemoglobin A1c < 7.0% (74.4% at baseline; no significant change over 24 months), it was more common in those who did not maintain glycemic control at 6 months (80.3%; P=0.0081). Elevated C-reactive protein, ALT, IL-6, and PAI-1 levels were more frequent with MetS. ConclusionsPersistent high prevalence of MetS in youth-onset diabetes, even with excellent glycemic control, is of concern given the associated increased cardiovascular risk.