HbA1c 与肥胖儿童和青少年的葡萄糖耐量异常。

HbA1c and glucose intolerance in obese children and adolescents.

机构信息

Department of Pediatrics, Ajou University School of Medicine, Ajou University Hospital, Suwon, Korea.

出版信息

Diabet Med. 2012 Jul;29(7):e102-5. doi: 10.1111/j.1464-5491.2012.03596.x.

DOI:10.1111/j.1464-5491.2012.03596.x

PMID:22273110

Abstract

AIMS

Childhood obesity is associated with an increased likelihood for having impaired glucose tolerance, dyslipidaemia and diabetes. The aim of the study was to evaluate HbA(1c) as a screening test for impaired glucose tolerance in obese children and adolescents and identify the optimal HbA(1c) threshold.

METHODS

We studied 126 obese and overweight children (BMI > 85 th percentile for age and gender) 4-17 years of age referred to the endocrine clinic at Ajou University Hospital in Korea. All subjects underwent HbA(1c) and oral glucose tolerance test.

RESULTS

Thirty-four patients (27%) out of 126 had impaired glucose tolerance. Silent diabetes was diagnosed in 10 adolescents (7.9%). Based on the receiver operating characteristic curve, the optimal cut point of HbA(1c) related to impaired glucose tolerance diagnosed by oral glucose tolerance test was 40 mmol/mol (5.8%), which was associated with a 64.7% sensitivity and 61.6% specificity, with an area under the receiver operating characteristic curve of 0.651 (95% CI 0.529-0.772).

CONCLUSIONS

Obesity is associated with an increased risk of impaired glucose tolerance. An HbA(1c) value of 40 mmol/mol (5.8%) should be used as a screening tool to identify children and adolescents with impaired glucose tolerance.

摘要

目的

儿童肥胖与葡萄糖耐量受损、血脂异常和糖尿病的发生几率增加有关。本研究旨在评估 HbA(1c) 作为肥胖儿童和青少年葡萄糖耐量受损的筛查试验，并确定最佳的 HbA(1c) 阈值。

方法

我们研究了韩国 Ajou 大学医院内分泌科就诊的 126 名肥胖和超重儿童（BMI 大于年龄和性别对应的第 85 百分位数）。所有受试者均接受了 HbA(1c) 和口服葡萄糖耐量试验。

结果

126 名患者中有 34 名（27%）存在葡萄糖耐量受损。10 名青少年（7.9%）被诊断为隐匿性糖尿病。基于受试者工作特征曲线，与口服葡萄糖耐量试验诊断的葡萄糖耐量受损相关的最佳 HbA(1c) 切点为 40mmol/mol（5.8%），其敏感性为 64.7%，特异性为 61.6%，受试者工作特征曲线下面积为 0.651（95%CI 0.529-0.772）。