PMID- 19620188
OWN - NLM
STAT- MEDLINE
DCOM- 20090813
LR  - 20221207
IS  - 1098-4275 (Electronic)
IS  - 0031-4005 (Linking)
VI  - 124
IP  - 2
DP  - 2009 Aug
TI  - Screening for type 2 diabetes in obese youth.
PG  - 573-9
LID - 10.1542/peds.2008-2949 [doi]
AB  - OBJECTIVE: To assess available blood tests as potential screening tools for 
      impaired glucose tolerance (IGT) and type 2 diabetes mellitus (T2DM). METHODS: We 
      studied 468 obese (BMI mean: 34.4 kg/m(2)) children, including a subgroup with 
      serum fasting insulin levels of >15 microIU/mL. Fasting laboratory tests included 
      measurements of serum glucose and insulin, hemoglobin A1c (HbA1c), and 
      1,5-anhydroglucitol (insulin-resistant subgroup only) levels. An oral 
      glucose-tolerance test was performed on each patient, and 2-hour postload serum 
      glucose and insulin levels were obtained. Fasting blood glucose (BG), Homeostasis 
      Model of Assessment for Insulin Resistance (HOMA-IR), HbA1c, and 
      1,5-anhydroglucitol values were used as predictors for exceeding various 2-hour 
      BG cut-offs. Receiver operator characteristic curves were fitted to determine 
      area-under-the-curve values as measures of screening efficacy. RESULTS: In the 
      insulin-resistant subgroup, 3 (2%) patients had T2DM and 23 (12%) had IGT. 
      Optimal sensitivity and specificity to detect T2DM were, respectively, 99% and 
      96% at HbA1c >or= 6.0%, and 96% and 88% at 1,5-anhydroglucitol < 17.0 microg/mL, 
      with lower values for fasting BG and the HOMA-IR. In the entire study group, 9 
      (2%) patients had T2DM and 44 (9%) had IGT. Optimal sensitivity and specificity 
      to detect T2DM were, respectively, 86% and 85% at HbA1c levels of 5.7%, 88%, and 
      93% at a fasting BG level of 104 mg/dL, and 62% and 70% at an HOMA-IR of 7.9. 
      CONCLUSIONS: HbA1c, 1,5-anhydroglucitol, and fasting BG levels are good 
      predictors of T2DM in obese children, whereas HOMA-IR values are not. HbA1c and 
      1,5-anhydroglucitol are excellent predictors of T2DM in insulin-resistant obese 
      children.
FAU - Shah, Shuchi
AU  - Shah S
AD  - Department of Pediatrics, University of Texas Southwestern Medical Center, 
      Dallas, Texas 75390-9063, USA.
FAU - Kublaoui, Bassil M
AU  - Kublaoui BM
FAU - Oden, Jon D
AU  - Oden JD
FAU - White, Perrin C
AU  - White PC
LA  - eng
PT  - Journal Article
DEP - 20090720
PL  - United States
TA  - Pediatrics
JT  - Pediatrics
JID - 0376422
RN  - 0 (Blood Glucose)
RN  - 0 (Glycated Hemoglobin A)
RN  - 0 (Insulin)
RN  - 0 (hemoglobin A1c protein, human)
RN  - 54BB3B7XMZ (1,5-anhydroglucitol)
RN  - 9G2MP84A8W (Deoxyglucose)
SB  - IM
MH  - Adolescent
MH  - Age Factors
MH  - Blood Glucose/metabolism
MH  - Body Mass Index
MH  - Child
MH  - Deoxyglucose/blood
MH  - Diabetes Mellitus, Type 2/blood/*diagnosis/*epidemiology
MH  - Female
MH  - Glucose Tolerance Test
MH  - Glycated Hemoglobin/metabolism
MH  - Humans
MH  - Hyperglycemia/blood/*diagnosis/*epidemiology
MH  - Insulin/blood
MH  - Insulin Resistance/physiology
MH  - Male
MH  - *Mass Screening
MH  - Obesity/blood/*epidemiology
MH  - Predictive Value of Tests
MH  - ROC Curve
MH  - Texas
EDAT- 2009/07/22 09:00
MHDA- 2009/08/14 09:00
CRDT- 2009/07/22 09:00
PHST- 2009/07/22 09:00 [entrez]
PHST- 2009/07/22 09:00 [pubmed]
PHST- 2009/08/14 09:00 [medline]
AID - peds.2008-2949 [pii]
AID - 10.1542/peds.2008-2949 [doi]
PST - ppublish
SO  - Pediatrics. 2009 Aug;124(2):573-9. doi: 10.1542/peds.2008-2949. Epub 2009 Jul 20.