title: Lack of agreement between the revised criteria of impaired fasting glucose and impaired glucose tolerance in children with excess body weight.
abstract: OBJECTIVE
  The aim of this study was to describe the agreement between impaired glucose tolerance (IGT) and impaired fasting glucose (IFG) in children with excess body weight using the original and the revised definitions of IFG.
  
  
  METHODS
  Obese and overweight children aged 4-17 years were included (n = 533). Anthropometric parameters and biochemical tests (fasting and 2-h glucose tests after an oral glucose load [1.75 g/kg]) were performed. Case subjects with a fasting plasma glucose >/=126 mg/dl were excluded. The diagnostic parameters of the original and the revised definitions of IFG for detecting IGT were estimated. The analysis of agreement between these categories was made using the kappa test.
  
  
  RESULTS
  The prevalence of IFG increased from 6.2 to 13.3% using the new criteria. The prevalence of IFG became closer to the prevalence of IGT (14.8%). The revised criteria increased the sensitivity from 26.6 to 36.7%. However, the new IFG definition was not useful for identifying IGT cases. Of the 71 case subjects with IFG, only 29 (40.8%) had IGT. In addition, 50 case subjects with IGT (9.4%) and 13 with diabetes (2.4%) had a fasting glycemia <100 mg/dl. A poor agreement was found between the 2003 IFG definition and abnormal 2-h postchallenge plasma glucose (kappa = 0.359). The proportion of false-positive cases increased (36.3-59.1%) under the new definition.
  
  
  CONCLUSIONS
  The new definition modestly increases the sensitivity of IFG for detecting IGT in children with excess body weight. Despite this, more than one-half of these cases are not detected. In addition, the false-positive rate was increased by 61%.
authors.affiliation: Servicio de Endocrinología Pediátrica, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México City, D.F., México. ritagomezdiaz@netscape.net
authors.forename: Rita
authors.initials: R
authors.lastname: Gómez-Díaz
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Aguilar-Salinas
authors.forename: Segundo
authors.initials: S
authors.lastname: Morán-Villota
authors.forename: Rosalinda
authors.initials: R
authors.lastname: Barradas-González
authors.forename: Rocio
authors.initials: R
authors.lastname: Herrera-Márquez
authors.forename: Miguel
authors.initials: M
authors.lastname: Cruz López
authors.forename: Jesus
authors.initials: J
authors.lastname: Kumate
authors.forename: Niels H
authors.initials: NH
authors.lastname: Wacher
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000378:metabolism*; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D005215:Fasting; D005260:Female; D018149:Glucose Intolerance / Q000145:classification / Q000453:epidemiology*; D005951:Glucose Tolerance Test; D006801:Humans; D008297:Male; D008800:Mexico / Q000453:epidemiology; D009765:Obesity / Q000145:classification / Q000453:epidemiology*; D018579:Patient Selection; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity
chemical_list: D001786:Blood Glucose