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Screening Markers of Impaired Glucose Tolerance in the Obese Pediatric Population
Ist Teil von
Hormone research in paediatrics, 2010-01, Vol.73 (2), p.102-107
Ort / Verlag
Basel, Switzerland: S. Karger AG
Erscheinungsjahr
2010
Link zum Volltext
Quelle
MEDLINE
Beschreibungen/Notizen
Background: With the epidemic of childhood obesity, it is crucial to devise a simple screening protocol to predict impaired glucose tolerance (IGT) or pre-diabetes. The oral glucose tolerance test (OGTT), which is the gold standard for the diagnosis of IGT, is impractical for screening purposes. This pilot study was designed to formulate a simple, sensitive algorithm to predict IGT using clinical and laboratory parameters. Methods: Ethnicity, family history of diabetes, pubertal status, BMI z-score, blood pressure, lipids, hemoglobin A1c (HbA1c) and OGTT data were retrospectively collected from 209 overweight multi-ethnic subjects aged 3–21 years. Multivariate logistic regression was used to determine independent predictors of IGT. Results: HbA1c was the only significant predictor of IGT (p = 0.001), whereas fasting glucose was not. A cut-off of 5.5% had the best combined sensitivity (85.7%) and specificity (56.9%) with an odds ratio of 7.9 of having IGT when HbA1c is ≧5.5%. The remaining clinical parameters were not significant predictors of IGT. Conclusion: While fasting blood glucose does not seem to be a predictor of IGT, we propose that HbA1c ≧5.5% can be used as a screening test to assess the risk of IGT and to determine who should undergo diagnostic OGTT. Large prospective studies validating our findings are warranted.