Stuttering and Incident Type 2 Diabetes: A Population-Based Study of 2.2 Million Adolescents

Abstract

Purpose To investigate the association between stuttering in adolescence and incident type 2 diabetes in young adulthood. Methods This nationwide population-based study included 2 193 855 adolescents of age 16 to 20 years who were assessed for military service between 1980 and 2013. Diagnoses of stuttering in adolescence were confirmed by a speech-language pathologist. Diabetes status for each individual as of December 31, 2016, was determined by linkage to the Israeli National Diabetes Registry. Relationships were analyzed using regression models adjusted for socioeconomic variables, cognitive performance, coexisting morbidities, and adolescent body mass index. Results Analysis was stratified by sex (Pinteraction = 0.035). Of the 4443 (0.4%) adolescent men with stuttering, 162 (3.7%) developed type 2 diabetes, compared with 25 678 (2.1%) men without stuttering (adjusted odds ratio [OR] 1.3; 95% CI, 1.1-1.6). This relationship persisted when unaffected brothers of men with stuttering were used as the reference group (adjusted OR = 1.5; 95% CI, 1.01-2.2), or when the analysis included only adolescents with unimpaired health at baseline (adjusted OR = 1.4; 95% CI, 1.1-1.7). The association was stronger in later birth cohorts, with an adjusted OR of 2.4 (1.4-4.1) for cases of type 2 diabetes before age 40. Of the 503 (0.1%) adolescent women with stuttering 7 (1.4%) developed type 2 diabetes, compared with 10 139 (1.1%) women without stuttering (OR = 2.03; 95% CI, 0.48-2.20). Conclusions Adolescent stuttering is associated with an increased risk for early-onset type 2 diabetes among men.

Adolescent Blood Pressure and the Risk for Early Kidney Damage in Young Adulthood

“…Several additional analyses, all utilizing the adjusted model, were conducted limiting the study sample to (1) adolescents with unimpaired health at baseline to minimize confounding by coexisting morbidity; unimpaired health at baseline was defined as the absence of chronic morbidities, of any chronically prescribed medications, and of a history of cancer, major surgery, or any chronic disease that required a medical follow-up 25 ; (2) people who were members of MHS until the end of the study; (3) people who underwent a subsequent serum creatinine or urine albumin test throughout the study, and their follow-up ended at the last known kidney assessment (at the latest); (4) people with at least 20 years follow-up to ensure that the findings were not affected by differences in follow-up periods; (5) follow-up after a 10-year washout interval to minimize confounding by undiagnosed conditions associated with kidney damage; (6) people who did not develop diabetes throughout the entire study period to minimize confounding by hyperglycemia. We also analyzed (7) all incidences of kidney damage, regardless of their clinical severity; (8) stage 1 and stage 2 kidney damage as separate outcomes; (9) participants stratified by smoking status (nonsmoker/ever smoker) at the end of follow-up; (10) the onset of kidney damage was tested using various age cutoffs (30, 35, and 40 years) to define better the temporal course of kidney damage risk among young adults; (11) incidences that might have occurred before the establishment of the MHS chronic kidney disease registry.…”

Adolescent Body Mass Index and Early Chronic Kidney Disease in Young Adulthood

“…First, only adolescents with unimpaired health at baseline were included to minimize confounding by coexisting morbidity. Unimpaired health at baseline was defined as the absence of any medical condition that requires prescribed long-term medications or medical follow-up (eg, asthma with routine inhaler use or hypothyroidism with long-term levothyroxine use), a history of cancer, or major surgery . Second, only persons with at least 5 years of follow-up were included to minimize baseline misclassification as being without CKD.…”

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

“…The medical assessment included review of the examinee’s medical history, an interview with a physician, physical examination and further medical tests as appropriate [ 20 , 21 ]. Height and weight were measured (barefoot and in underwear) by trained medics, and BMI was calculated (weight in kilograms divided by height squared in meters) [ 22 ].…”