{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T07:26:31Z","timestamp":1791530791692,"version":"4.3.4"},"reference-count":32,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T00:00:00Z","timestamp":1771977600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosglobalpublichealth.org"],"crossmark-restriction":false},"short-container-title":["PLOS Glob Public Health"],"abstract":"<jats:p>Prediabetes and type 2 diabetes mellitus (T2DM) are emerging public health concerns among adolescents in the United States (U.S.), with early onset increasing the risk of lifelong complications. This study analyzed the prevalence and factors associated with prediabetes\/T2DM among 1,998 adolescents (10\u201319 years) in the U.S. using data from the National Health and Nutrition Examination Surveys (2021\u20132023). Prediabetes\/T2DM were defined as hemoglobin A1c (HbA1c) \u2265 5.7% or fasting plasma glucose (FPG) \u2265 100 mg\/dL. Unweighted univariate and multiple logistic regression models were used to identify predictors of prediabetes\/T2DM among adolescents. Overall, 30.8%\u2014nearly 1 in 3 American adolescents\u2014had prediabetes or T2DM. In univariate analysis, older age (OR = 0.93, p\u2009=\u20090.045), female gender (OR = 0.50, p\u2009=\u20090.001), overweight\/obesity (OR = 1.57, p\u2009=\u20090.012), elevated waist-to-height ratio (OR = 24.04, p\u2009=\u20090.002), total daily sugar intake (OR = 1.003; p\u2009=\u20090.042), low HDL cholesterol (\u226445 mg\/dL) (OR = 1.41; p\u2009=\u20090.032), higher systolic blood pressure (OR = 1.02, p\u2009=\u20090.002) and higher diastolic blood pressure (OR = 1.02, p\u2009=\u20090.037) were significantly associated with the odds of having prediabetes\/T2DM. However, in multiple logistic regression analysis, significant predictors included older age (AOR\u2009=\u20090.91; p\u2009=\u20090.025), female gender (AOR\u2009=\u20090.52; p\u2009=\u20090.002), and elevated waist-to-height ratio (AOR\u2009=\u2009146.19; p\u2009=\u20090004). Although male gender and younger age showed increased risk, central adiposity\u2014specifically measured by waist-to-height ratio\u2014emerged as the strongest independent predictor of prediabetes\/T2DM compared to general overweight\/obesity (BMI). These findings underscore the need for early screening and targeted prevention strategies focusing on central adiposity and demographic risk factors.<\/jats:p>","DOI":"10.1371\/journal.pgph.0005596","type":"journal-article","created":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T18:21:51Z","timestamp":1772043711000},"page":"e0005596","update-policy":"https:\/\/doi.org\/10.1371\/journal.pgph.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Prevalence and predictors of prediabetes\/type 2 diabetes mellitus among adolescents in the United States: NHANES (2021\u20132023)"],"prefix":"10.1371","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-1463-5166","authenticated-orcid":true,"given":"Eric","family":"Peprah Osei","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,2,25]]},"reference":[{"issue":"2","key":"pgph.0005596.ref001","doi-asserted-by":"crossref","DOI":"10.1001\/jamapediatrics.2019.4498","article-title":"Prevalence of prediabetes among adolescents and young adults in the United States, 2005-2016","volume":"174","author":"LJ Andes","year":"2020","journal-title":"JAMA Pediatr"},{"issue":"2","key":"pgph.0005596.ref002","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1089\/dia.2022.0340","article-title":"A longitudinal view of disparities in insulin pump use among youth with type 1 diabetes: The SEARCH for diabetes in youth study","volume":"25","author":"EM Everett","year":"2023","journal-title":"Diabetes Technology & Therapeutics"},{"issue":"9","key":"pgph.0005596.ref003","doi-asserted-by":"crossref","first-page":"1447","DOI":"10.1016\/j.jand.2015.02.031","article-title":"Lifestyle weight-loss intervention outcomes in overweight and obese adults with type 2 diabetes: a systematic review and meta-analysis of randomized clinical trials","volume":"115","author":"MJ Franz","year":"2015","journal-title":"J Acad Nutr Diet"},{"key":"pgph.0005596.ref004","volume-title":"NIDDK Recent Advances & Emerging Opportunities","author":"National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)","year":"2024"},{"key":"pgph.0005596.ref005","article-title":"14. 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