title: HbA1c and glucose intolerance in obese children and adolescents.
abstract: OBJECTIVE
  Childhood obesity is associated with an increased likelihood for having impaired glucose tolerance, dyslipidaemia and diabetes. The aim of the study was to evaluate HbA(1c) as a screening test for impaired glucose tolerance in obese children and adolescents and identify the optimal HbA(1c) threshold.
  
  
  METHODS
  We studied 126 obese and overweight children (BMI > 85 th percentile for age and gender) 4-17 years of age referred to the endocrine clinic at Ajou University Hospital in Korea. All subjects underwent HbA(1c) and oral glucose tolerance test.
  
  
  RESULTS
  Thirty-four patients (27%) out of 126 had impaired glucose tolerance. Silent diabetes was diagnosed in 10 adolescents (7.9%). Based on the receiver operating characteristic curve, the optimal cut point of HbA(1c) related to impaired glucose tolerance diagnosed by oral glucose tolerance test was 40 mmol/mol (5.8%), which was associated with a 64.7% sensitivity and 61.6% specificity, with an area under the receiver operating characteristic curve of 0.651 (95% CI 0.529-0.772).
  
  
  CONCLUSIONS
  Obesity is associated with an increased risk of impaired glucose tolerance. An HbA(1c) value of 40 mmol/mol (5.8%) should be used as a screening tool to identify children and adolescents with impaired glucose tolerance.
authors.affiliation: Department of Pediatrics, Ajou University School of Medicine, Ajou University Hospital, Suwon, Korea.
authors.forename: H S
authors.initials: HS
authors.lastname: Lee
authors.forename: H K
authors.initials: HK
authors.lastname: Park
authors.forename: J S
authors.initials: JS
authors.lastname: Hwang
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D005215:Fasting / Q000097:blood*; D005260:Female; D018149:Glucose Intolerance / Q000097:blood* / Q000453:epidemiology; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D008297:Male; D008403:Mass Screening; D009765:Obesity / Q000097:blood* / Q000453:epidemiology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D012680:Sensitivity and Specificity
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human