Criteria for oral glucose tolerance testing of obese minority youth.
OBJECTIVE
To identify those obese minority youth at greatest risk for having an abnormal oral glucose tolerance test (OGTT) indicating impaired glucose tolerance (IGT) or type 2 diabetes mellitus (DM2).


METHODS
167 children, who met the ADA criteria for T2DM screening, underwent an OGTT. Logistic regression models were derived for girls, boys, and both. Based on significant variables, algorithms yielding 100% sensitivity were derived to identify candidates for screening.


RESULTS
12% of children screened had an abnormal OGTT. Girls who met the algorithm criteria for screening (HOMA > 4.5) had an abnormal OGTT with a sensitivity of 100% (95% confidence interval [CI] 0.988-1.0) and specificity of 53.7% (95% CI 0.41-0.648). Boys who met the algorithm screening criteria (HOMA >13, or HbAlc > 5.8%, or total cholesterol > 200 mg/dl) had an abnormal OGTT with a sensitivity of 100% (95% CI 0.979-1.000) and specificity of 76.6% (95% CI 0.632-0.849). The model was validated using a large patient sample, yielding similar results.


CONCLUSIONS
In obese pubertal minority youth meeting the ADA criteria for DM2 screening, these algorithm screening criteria can be useful in identifying those at risk youth who should undergo an OGTT.
Division of Pediatric Endocrinology, Children's Hospital at Montefiore, Bronx, NY, USA.
Mala
M
Puri
Katherine
K
Freeman
Mireya
M
Garcia
Hadassa
H
Nussbaum
Joan R
JR
Dimartino-Nardi
D000293:Adolescent; D001741:Black or African American / Q000706:statistics & numerical data; D000465:Algorithms; D001786:Blood Glucose; D002648:Child; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000208:ethnology; D005260:Female; D018149:Glucose Intolerance / Q000175:diagnosis / Q000208:ethnology; D005951:Glucose Tolerance Test; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D009765:Obesity / Q000175:diagnosis* / Q000208:ethnology*; D018579:Patient Selection; D012680:Sensitivity and Specificity
D001786:Blood Glucose