High-normal fasting glucose levels are associated with increased prevalence of impaired glucose tolerance in obese children.
The natural history of impaired glucose tolerance (IGT) and Type 2 diabetes among obese children is not clear. Although the cut-off for impaired fasting glucose (IFG) has recently been changed from 110 (6.1 mmol/l) to 100 mg/dl (5.6 mmol/l), it does not seem a reliable way to find all subjects with impaired glucose homeostasis. The aim of our study was to determine whether high-normal fasting glucose level could predict the occurrence of IGT and metabolic syndrome. Three hundred and twenty-three Italian obese children and adolescents were included in the study (176 females, mean age 11+/-2.9 yr; mean body mass index z-score: 3+/-0.6). Waist circumference, serum glucose, insulin, triglyceride, cholesterol HDL, blood pressure were evaluated and an oral glucose tolerance test (OGTT) was performed. The prevalence of IFG and IGT were respectively 1.5% (5 subjects) and 5% (18 patients); no diabetic patients were found. Metabolic syndrome was diagnosed in 20% of patients. Fasting glycemia values <100 mg/dl (5.6 mmol/l) have been divided in quintiles. Metabolic syndrome prevalence increased across quintiles, although not in a statistically significantly manner, but it could depend on the selected diagnostic criteria as no univocal definition exists for metabolic syndrome in youths. Interestingly high-normal fasting plasma glucose levels constitute an independent risk factor for IGT among obese children and adolescents; therefore, this very easy-to-use parameter may help to identify obese patients at increased risk of diabetes or at least could suggest in which subjects to perform an OGTT.
Grandone
A
A
Department of Pediatrics F. Fede, Second University of Naples, Naples, Italy.
Amato
A
A
Luongo
C
C
Santoro
N
N
Perrone
L
L
del Giudice
E Miraglia
EM
D000293:Adolescent; D001786:Blood Glucose / Q000032:analysis / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D005215:Fasting / Q000097:blood* / Q000378:metabolism; D005260:Female; D018149:Glucose Intolerance / Q000097:blood / Q000150:complications / Q000453:epidemiology* / Q000378:metabolism; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000453:epidemiology; D009765:Obesity / Q000097:blood / Q000150:complications / Q000453:epidemiology* / Q000378:metabolism; D015995:Prevalence; D015854:Up-Regulation
D001786:Blood Glucose