Cross-sectional Associations among Fitness, Dyslipidemia, Body Adiposity Indexes and Type 2 Diabetes Mellitus Risk in Adolescents

Abstract

The prevalence of type 2 diabetes mellitus (T2DM) in adolescents is rising, correlating with the global increase in obesity and physical inactivity. This study aims to examine the individual and combined associations of cardiorespiratory fitness (CRF), atherogenic index of plasma (AIP), conicity index (C-index), visceral adiposity index (VAI), and the product of triglyceride and glucose (TyG) with fasting plasma glucose (FPG), an established marker of type 2 diabetes mellitus (T2DM) in Nigerian adolescents. This cross-sectional study included a sample of 403 adolescents (201 girls and 202 boys) aged 11–19 years. Participants were assessed for all independent and dependent variables using standard procedures. Regression models adjusted for age and sexual maturity were used to determine the associations between these health markers and T2DM risk. Among the high-risk adolescents, 56.6% were at risk of central obesity, 49.1% had low fitness, 46.2% were susceptible to insulin resistance, and 33.5% had dyslipidemia. After controlling for confounding variables, all health markers were independently and jointly associated with T2DM risk, with TyG displaying the strongest explanatory power (females: β = 2.163, p = 0.001; males: β = 0.748, p < 0.001). Females with elevated TyG indices were 46.6 times more likely to be at risk of T2DM, while the odds of males having high TyG being at risk of T2DM was 3.6. Health markers were independently and jointly associated with T2DM risk in adolescents, with TyG, C-index, and VAI contributing most significantly. Promoting healthy diet, weight management and endurance physical activities among adolescents is crucial for improving metabolic health.