Elevated fasting triglycerides predict impaired glucose tolerance in adolescents at risk for type 2 diabetes.
OBJECTIVE
The aim of this study was to evaluate whether fasting laboratory values can predict impaired glucose tolerance (IGT) in adolescents who are at risk for developing type 2 diabetes mellitus (T2DM).


OBJECTIVE
Elevated fasting triglycerides, a marker for worsening insulin resistance, predict risk for IGT.


METHODS
Following a fast of at least 9 h, laboratory measures, body mass index (BMI), and demographic information were obtained. The subjects then underwent a 75-g oral glucose challenge with a 2-h postchallenge glucose determination.


METHODS
Eighty-four adolescents aged 12-20 yr with at least two risk factors for developing T2DM (obesity, family history of T2DM, or acanthosis nigricans) and with either a fasting insulin level > or =25 microU/mL or a homeostasis model assessment of insulin resistance (HOMA-IR) > or =3.5 were recruited for the study.


RESULTS
Ten subjects (12%) had IGT [2-h glucose > or =140 mg/dL (7.77 mmol/L)], and 10 subjects (12%) had impaired fasting glucose [IFG; fasting glucose > or =100 mg/dL (5.55 mmol/L)]. However, only three (30%) subjects with IGT had IFG, though all subjects with IGT had a fasting triglyceride level > or =150 mg/dL (1.70 mmol/L). Of those subjects with elevated triglycerides, 29% had IGT. As a screening test to predict risk for IGT, elevated triglycerides >150 mg/dL had a sensitivity of 100% and a specificity of 68%. The positive predictive value was 29%, and the negative predictive value was 100%.


CONCLUSIONS
Screening with fasting glucose alone would have missed 70% of subjects with IGT in this population of insulin-resistant adolescents. However, a fasting triglyceride level > or =150 mg/dL was strongly associated with IGT and may help to identify at-risk adolescents who should undergo formal glucose tolerance testing.
Love-Osborne
Kathy
K
Division of Adolescent Medicine, Department of Pediatrics, University of Colorado Health Sciences Center, Denver, CO, USA. kathryn.love-osborne@dhha.org
Butler
Nancy
N
Gao
Dexiang
D
Zeitler
Phil
P
D000293:Adolescent; D000328:Adult; D002648:Child; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology*; D005215:Fasting / Q000097:blood*; D005260:Female; D018149:Glucose Intolerance / Q000097:blood / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D009765:Obesity / Q000150:complications; D012372:ROC Curve; D012306:Risk; D012680:Sensitivity and Specificity; D014280:Triglycerides / Q000097:blood*
D014280:Triglycerides