The Risk Factors of Prediabetes in Adolescents: A Systematic Review

Background: Pre-diabetes is a risk state for the future development of type 2 diabetes. The risk factors for prediabetes have been categorized as modifiable and non-modifiable. However, conclusive evidence regarding the risk factors associated with pre-diabetes in adolescence is still lacking. This study aims to answer the question of: which risk factors are most associated with the incidence of prediabetes in adolescents? Methods: This review was conducted in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. A systematic search was conducted in PubMed, ScienceDirect, Scopus and Web of Science electronic databases using the keywords of “modifiable risk factors”, “non-modifiable risk factors”, “pre-diabetes” and “adolescent” in the time frame of 2010 to 2021. Eligibility criteria were determined based on the (population, intervention, comparison and outcomes) PICOS guidelines. Reference list from identified studies was used to augment the search strategy. Two authors assessed the quality and risk of bias of the studies using National Institute of Health (NIH) Quality assessment tool. Qualitative analysis method was used to review the articles. Based on this, components such as purpose, methodology, risk factors, measurement method and main findings were extracted.  Results: As a result of the initial search, 3982 studies were obtained. All duplicates, case reports, reviews and non-English studies were excluded. A total of ten articles that met the pre-defined eligibility criteria were included in this review. The quality of included studies was mostly in the good category. Overall, the association between risk factors and adolescents’ prediabetes appeared to be strongest among modifiable factors such as physical activity, poor diet, smoking, and cardiometabolic factors. The most significant modifiable factor was body mass index (BMI) and the most significant non-modifiable factor was gender. Conclusion: Considering the prominent role of modifiable risk factors in the occurrence of prediabetes in adolescents, it seems necessary to include lifestyle modification programs for this age group. It is also important to pay attention to gender as a non-modifiable factor in the development of prediabetes in adolescents.