PMID- 24671874
OWN - NLM
STAT- MEDLINE
DCOM- 20151229
LR  - 20221207
IS  - 1938-2707 (Electronic)
IS  - 0009-9228 (Linking)
VI  - 53
IP  - 8
DP  - 2014 Jul
TI  - Screening obese children and adolescents for prediabetes and/or type 2 diabetes 
      in pediatric practices: a validation study.
PG  - 771-6
LID - 10.1177/0009922814528571 [doi]
AB  - BACKGROUND: Increased prevalence of type 2 diabetes mellitus (T2DM) makes it 
      important for pediatricians to use effective screening tools for risk assessment 
      of prediabetes/T2DM in children. METHODS: Children (n = 149) who had an oral 
      glucose tolerance test (OGTT) and glycated hemoglobin (HbA1c) were studied. 
      American Diabetes Association recommended screening criteria-HbA1c >/=5.7% and 
      fasting plasma glucose (FPG) >/=100 mg/dL-were compared against OGTT. The 
      homeostatic model assessment of insulin resistance (HOMA-IR), a mathematical 
      index derived from fasting insulin and glucose, was compared with OGTT. We 
      studied whether combining screening tests (HbA1c and fasting glucose or HbA1c and 
      HOMA-IR) improved accuracy of prediction of the OGTT. RESULTS: HbA1c of >/=5.7% had 
      a sensitivity of 75% and specificity of 57% when compared with the OGTT. 
      Combining screening tests (HbA1c >/=5.7% and FPG >/=100 mg/dL; HbA1c >/=5.7% and 
      HOMA-IR >/=3.4) resulted in improved sensitivity (95.5% for each), with the 
      HbA1c-FPG doing better than the HbA1c-HOMA-IR combination in terms of ability to 
      rule out prediabetes (likelihood ratio [LR]) negative. 0.07 vs 0.14). 
      CONCLUSIONS: HbA1c of >/=5.7% provided fair discrimination of glucose tolerance 
      compared with the OGTT. The combination of HbA1c and FPG is a useful method for 
      identifying children who require an OGTT.
CI  - (c) The Author(s) 2014.
FAU - Brar, Preneet C
AU  - Brar PC
AD  - New York University School of Medicine, New York, NY, USA Preneet.brar@nyumc.org.
FAU - Mengwall, Lisa
AU  - Mengwall L
AD  - New York University School of Medicine, New York, NY, USA.
FAU - Franklin, Bonita H
AU  - Franklin BH
AD  - New York University School of Medicine, New York, NY, USA.
FAU - Fierman, Arthur H
AU  - Fierman AH
AD  - New York University School of Medicine, New York, NY, USA.
LA  - eng
PT  - Journal Article
PT  - Validation Study
DEP - 20140325
PL  - United States
TA  - Clin Pediatr (Phila)
JT  - Clinical pediatrics
JID - 0372606
RN  - 0 (Glycated Hemoglobin A)
SB  - IM
MH  - Adolescent
MH  - Age Distribution
MH  - Area Under Curve
MH  - Body Mass Index
MH  - Child
MH  - Child, Preschool
MH  - Databases, Factual
MH  - Diabetes Mellitus, Type 2/*diagnosis/epidemiology
MH  - Female
MH  - Glucose Intolerance/blood
MH  - Glucose Tolerance Test/methods
MH  - Glycated Hemoglobin/*analysis
MH  - Humans
MH  - Male
MH  - Mass Screening/*methods
MH  - Pediatric Obesity/*diagnosis/epidemiology
MH  - Prediabetic State/*diagnosis/epidemiology
MH  - Prevalence
MH  - ROC Curve
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Sex Distribution
MH  - United States
OTO - NOTNLM
OT  - children & adolescents
OT  - insulin resistance
OT  - obesity
OT  - prediabetes/ Type 2 diabetes
OT  - screening tools
EDAT- 2014/03/29 06:00
MHDA- 2015/12/30 06:00
CRDT- 2014/03/28 06:00
PHST- 2014/03/28 06:00 [entrez]
PHST- 2014/03/29 06:00 [pubmed]
PHST- 2015/12/30 06:00 [medline]
AID - 0009922814528571 [pii]
AID - 10.1177/0009922814528571 [doi]
PST - ppublish
SO  - Clin Pediatr (Phila). 2014 Jul;53(8):771-6. doi: 10.1177/0009922814528571. Epub 
      2014 Mar 25.