Groot Cornelis Jan de, Grond Jeroen van der, Delgado Yosine, Rings Edmond H H M, Hannema Sabine E, van den Akker Erica L T
J Pediatr Endocrinol Metab. 2017 Feb 1;30(2):189-196. doi: 10.1515/jpem-2016-0289.
There is debate on which overweight and obese children should be screened for the presence of impaired glucose tolerance (IGT) by oral glucose tolerance testing (OGTT). The objective of the study was to identify risk factors predictive of the presence of IGT.
In a cohort of overweight children, who underwent OGTT, we determined the association of anthropometric and laboratory parameters with IGT and whether combining parameters improved the sensitivity of screening for IGT.
Out of 145 patients, IGT was present in 11, of whom two had impaired fasting glucose (IFG). Elevated blood pressure (p=0.025) and elevated liver enzymes (p=0.003) were associated with IGT, whereas IFG was not (p=0.067), screening patients with either one of these parameters predicted IGT with a high sensitivity of 1.00, and a number needed to screen of 5.7.
Screening all patients with either IFG, presence of elevated blood pressure and elevated liver enzymes, significantly increases predictability of IGT compared to using IFG alone.
对于哪些超重和肥胖儿童应通过口服葡萄糖耐量试验(OGTT)筛查糖耐量受损(IGT)存在争议。本研究的目的是确定预测IGT存在的危险因素。
在一组接受OGTT的超重儿童中,我们确定了人体测量和实验室参数与IGT的关联,以及联合参数是否能提高IGT筛查的敏感性。
145例患者中,11例存在IGT,其中2例空腹血糖受损(IFG)。血压升高(p = 0.025)和肝酶升高(p = 0.003)与IGT相关,而IFG则不然(p = 0.067),筛查有这些参数之一的患者预测IGT的敏感性高达1.00,需筛查人数为5.7。
与单独使用IFG相比,筛查所有有IFG、血压升高和肝酶升高的患者,可显著提高IGT的预测性。