1 School of Public Health, Université de Montréal, 7101 Avenue du Parc, 3e étage, Montréal, Québec, Canada.
2 Research Center of Centre Hospitalier Universitaire Sainte-Justine, 3175, Chemin de la Côte-Sainte-Catherine, Montréal, Québec, Canada.
3 Research Centre of Centre Hospitalier Universitaire de Montréal, 900 Saint-Denis, Pavillon R, Montréal, Québec, Canada.
4 Ingram School of Nursing, McGill University, 680 Sherbrooke West, Montréal, Québec, Canada.
5 Department of Family Medicine, Faculty of Medicine and Health Sciences, McGill University, 5858 Chemin de la Côte-des-Neiges, Montréal, Québec, Canada.
6 School of Kinesiology and Physical Activity Sciences, Faculty of Medicine, Université de Montréal, 2100 Boulevard Édouard-Montpetit, Montréal, Québec, Canada.
7 PERFORM Centre and Department of Psychology, Faculty of Arts and Science, Concordia University, 7141 Sherbrooke W

Background: In children, the mechanisms implicated in deterioration of glucose homeostasis vs. reversion to normal glucose tolerance (NGT) remain uncertain.

Objective: Describe the natural history of dysglycemia from childhood to late adolescence and to identify its early determinants.

Methods: We used baseline (8-10 yrs, n=630), 1^st follow-up (10-12 yrs, n=564) and 2^nd follow-up (15-17 yrs, n=377) data from the QUALITY cohort of White Canadian children with parental obesity. Children underwent a 2-h oral glucose tolerance test at each cycle with plasma glucose and insulin measured at 0/30/60/90/120 minutes. American Diabetes Association criteria defined dysglycemia (impaired fasting glucose, impaired glucose tolerance or type 2 diabetes). Longitudinal patterns of insulin sensitivity and beta-cell function were estimated using generalized additive mixed models. Model averaging identified biological, sociodemographic and lifestyle-related determinants of dysglycemia.

Results: Of the children NGT at baseline, 66 (21%) developed dysglycemia without reverting to NGT. Among children with dysglycemia at baseline, 24 (73%) reverted to NGT. In children with dysglycemia at 1^st follow-up, 18 (53%) later reverted to NGT. Among biological, sociodemographic and lifestyle determinants at 8-10 yrs, only fasting and 2-h glucose were associated with developing dysglycemia (odds ratio [95% CI] per 1 mmol/L increase: 4.50 [1.06; 19.02] and 1.74 [1.11; 2.73], respectively). Beta-cell function decreased by 40% in children with overweight or obesity.

Conclusions: Up to 75% of children with dysglycemia reverted to NGT during puberty. Children with higher fasting and 2-h glucose were at higher risk for progression to dysglycemia, while no demographic/lifestyle determinants were identified. This article is protected by copyright. All rights reserved.