Utility of Childhood Glucose Homeostasis Variables in Predicting Adult Diabetes and Related Cardiometabolic Risk Factors The Bogalusa Heart Study

OBJECTIVE — This study examines the usefulness of childhood glucose homeostasis vari-ables (glucose, insulin, and insulin resistance index [homeostasis model assessment of insulin resistance {HOMA-IR}]) in predicting pre-diabetes and type 2 diabetes and related cardiometa-bolic risk factors in adulthood. RESEARCHDESIGNANDMETHODS — This retrospective cohort study consisted of normoglycemic (n 1,058), pre-diabetic (n 37), and type 2 diabetic (n 25) adults aged 19–39 years who were followed on average for 17 years since childhood. RESULTS — At least 50 % of the individuals who ranked highest (top quintile) in childhood for glucose homeostasis variables maintained their high rank by being above the 60th percentile in adulthood. In a multivariate model, the best predictors of adulthood glucose homeostasis variables were the change in BMI Z score from childhood to adulthood and childhood BMI Z score, followed by the corresponding childhood levels of glucose, insulin, and HOMA-IR. Fur-ther, children in the top decile versus the rest for insulin and HOMA-IR were 2.85 and 2.55 times, respectively, more likely to develop pre-diabetes; children in the top decile versus the rest for glucose, insulin, and HOMA-IR were 3.28, 5.54, and 5.84 times, respectively, more likely t