Adolescent Hypertension and Risk for Early-Onset Type 2 Diabetes: A Nationwide Study of 1.9 Million Israeli Adolescents

Fishman, Boris; Grossman, Ehud; Zucker, Inbar; Orr, Omri; Lutski, Miri; Bardugo, Aya; Bendor, Cole D.; Leiba, Yoav; Derazne, Estela; Mosenzon, Ofri; Tzur, Dorit; Beer, Zivan; Pinhas‐Hamiel, Orit; Fishman, Tamar; Afek, Arnon; Tirosh, Amir; Gerstein, Hertzel C.; Twig, Gilad

doi:10.2337/dc20-1752

Cited by 8 publications

(11 citation statements)

References 5 publications

(8 reference statements)

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“…The results of our study are of public health significance since elevated blood pressure among adolescents plays a substantial role in future cardiovascular morbidity and mortality [ 3 , 43 ]. This effect is mediated through the increased risk for adulthood hypertension as well as via induction of additional cardiovascular risk factors such as chronic kidney disease and diabetes [ 4 , 5 ]. Recently, adolescent hypertension has been shown to promote early onset type 2 diabetes [ 5 ] which has even more deleterious cardiovascular sequela compared to later onset diabetes [ 44 ].…”

Section: Discussionmentioning

confidence: 99%

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The opposing trends of body mass index and blood pressure during 1977–2020; nationwide registry of 2.8 million male and female adolescents

Fishman

Zloof

Orr

et al. 2021

Cardiovasc Diabetol

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Background Elevated blood pressure among adolescents has been shown to be associated with future adverse cardiovascular outcomes and early onset diabetes. Most data regarding systolic and diastolic blood pressure trends are based on surveys of selected populations within 10–20-year periods. The goal of this study was to characterize the secular trend of blood pressure given the rising prevalence of adolescent obesity. Methods This nationwide population-based study included 2,785,515 Israeli adolescents (41.6% females, mean age 17.4 years) who were medically evaluated and whose weight, height and blood pressure were measured, prior to mandatory military service between 1977 and 2020. The study period was divided into 5-year intervals. Linear regression models were used to describe the P for trend along the time intervals. Analysis of covariance was used to calculate means of blood pressure adjusted for body mass index. Results During the study period, the mean body mass index increased by 2.1 and 1.6 kg/m2 in males and females, respectively (P for trend < 0.001 in both sexes). The mean diastolic blood pressure decreased by 3.6 mmHg in males and by 2.9 mmHg in females (P < 0.001 in both sexes). The mean systolic blood pressure increased by 1.6 mmHg in males and decreased by 1.9 mmHg in females. These trends were also consistent when blood pressure values were adjusted to body mass index. Conclusion Despite the increase in body mass index over the last four decades, diastolic blood pressure decreased in both sexes while systolic blood pressure increased slightly in males and decreased in females.

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Section: Discussionmentioning

confidence: 99%

“…A number of studies have reported associations of adolescent elevated BP with adult hypertension and with renal and cardiovascular morbidity and mortality later in life [ 3 – 6 ]. Furthermore, adolescent elevated BP was found to promote early onset type 2 diabetes mellitus [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

The opposing trends of body mass index and blood pressure during 1977–2020; nationwide registry of 2.8 million male and female adolescents

Fishman

Zloof

Orr

et al. 2021

Cardiovasc Diabetol

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show abstract

“…This includes a detailed interview, review of medical history and a physical examination. Measurement of weight, height, and systolic and diastolic blood pressure were performed for most of the adolescents (98.5%) as described elsewhere [ 17 , 18 ]. Mean arterial pressure was calculated:

.…”

Section: Methodsmentioning

confidence: 99%

“…The INDR receives an annual dataset of the persons with diabetes from each of the four health maintenance organizations that provide medical services to almost all Israeli permanent residents. The pre-military assessment of adolescents was linked to the INDR using a coded de-identified civilian identification number [ 17 , 18 ]. The dataset reported to the INDR includes individual data on persons who met at least one of the following criteria in the previous year: (1) a single test of glycated hemoglobin (HbA1c) greater than or equal to 6.5%; (2) serum glucose concentrations of 200 mg/dL or higher in two tests performed at least 1 month apart in the same year; (3) at least three purchases of glucose lowering medication (including insulin) in different months.…”

Section: Methodsmentioning

confidence: 99%

“…In addition, we conducted two sensitivity analyses. First, the study sample was restricted to individuals with unimpaired health status at study entry (absence of a medical history of cancer or major surgery, absence of mental disorders or a need for a chronic medical treatment or follow-up), to minimize confounding by coexisting medical illness [ 17 , 18 ]. Second, the outcome was defined as the onset of type 2 diabetes before age 30 years, to better characterize the hazard associated in early young adulthood.…”

Section: Methodsmentioning

confidence: 99%

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Adolescent cognitive function and incident early-onset type 2 diabetes

et al. 2021

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Background Cognitive function among apparently healthy adolescents has been associated with cardiovascular morbidity and mortality. We examined the relationship between global and subdomain cognitive scores in adolescence and early-onset type 2 diabetes (T2D) in men and women. Methods A nationwide, population-based study of 971,677 Israeli born adolescents (56% men; mean age 17.4 years) who were medically examined and their cognitive performance was assessed before compulsory military service during 1992–2010. Data included global and subdomain cognitive Z -scores (problem-solving, verbal abstraction and categorization, verbal comprehension, and mathematical abilities). Data were linked to the Israeli National Diabetes Registry. The relations between global and subdomain scores and incident T2D was determined using Cox proportional hazard models and logistic regression models. Analyses were conducted separately for men and women. Findings During 16,095,122 person-years, 3,570 individuals developed T2D. After adjustment, those in the low compared to the high quintile of global cognitive Z -score had the highest risk for T2D; HR 2.46, (95% CI 2.10–2.88) for men and 2.33 (95% CI 1.88–2.89) for women. A one-unit lower global cognitive Z -score was associated with 1.41 (95% CI 1.34–1.48) and 1.46 (95% CI 1.36–1.56) increased risks for men and women, respectively. The relationship was noted for the cognitive subdomains scores as well as for the global cognitive score, with no heterogeneity across cognitive subdomains. Interpretation This large nationally representative cohort suggests relationship between global, as well as subdomain cognitive scores in late adolescence, and incident early onset T2D in both sexes, which was independent of socioeconomic status.

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Tea combats circadian rhythm disorder syndrome via the gut-liver-brain axis: potential mechanisms speculated

Luo

Zeng

2022

Critical Reviews in Food Science and Nutrition

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Adolescent Hypertension and Risk for Early-Onset Type 2 Diabetes: A Nationwide Study of 1.9 Million Israeli Adolescents

Cited by 8 publications

References 5 publications

The opposing trends of body mass index and blood pressure during 1977–2020; nationwide registry of 2.8 million male and female adolescents

The opposing trends of body mass index and blood pressure during 1977–2020; nationwide registry of 2.8 million male and female adolescents

Adolescent cognitive function and incident early-onset type 2 diabetes

Tea combats circadian rhythm disorder syndrome via the gut-liver-brain axis: potential mechanisms speculated

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