Abnormal Glucose In Pre-School Children And The Association With Obesity/Physical Activity: A Large Population-Based Study

Aim The rise of diabetes mellitus (DM) and impaired fasting glucose (IFG) in children has become a worldwide challenge, but population-based survey targeted on pre-school children is lacking. The aim of the study was to determine the prevalence of DM and IFG in pre-school children and their association with obesity and susceptible behaviours.Methods A population-based survey was conducted and 21,571 Chinese children aged 5-6 years were recruited from 66 kindergartens in Tianjin, China during the year of 2016-2018. Fasting glucose was measured for all participants. Children with fasting glucose over 7.0 mmol/L was defined as DM, and 5.6-6.9 mmol/L was defined as IFG.Results The prevalence of DM and IFG in the current study among Chinese children aged 5-6 years old was 0.05% and 1.18%, respectively, with significant gender and regional disparities (p < 0.001). The risk of abnormal fasting glucose increased with obesity (OR 1.44, 95% CI 1.00-2.06, p < 0.05), especially with moderate/severe obesity (OR 1.84, 95% CI 1.10-3.10, p < 0.05). Further analyses found that as compared to children who had at least 2 h/day physical activity, physical activity <1 h/day increased the risk of abnormal fasting glucose independently of BMI z-score (OR 1.79, 95% CI 1.10-2.91, p < 0.05).Conclusions The study was the first population-based large-scale survey of DM and IFG which targeted on pre-school children, and demonstrated that moderate/severe obesity and inadequate physical activity raised the risk of DM and IFG early from pre-school. The findings highlighted the necessity of early detection for abnormal glucose and control of obesity and susceptible behaviours.