title: Longitudinal multicenter analysis on the course of glucose metabolism in obese children.
abstract: OBJECTIVE
  Although there is evidence of increasing prevalence of impaired glucose metabolism in obese children from smaller single cohorts, data are lacking on the progression of glucose metabolism in this patient group.We aimed to assess the prevalence and the longitudinal course of impaired glucose metabolism assessed by oral glucose tolerance test (oGTT) in a large multi-center pediatric obesity registry.
  
  
  METHODS
  We performed an observational multicenter (n=84) cross-sectional (n=11 156) and longitudinal analysis (n=1008) on the course of glucose metabolism evaluated by oGTT in obese children documented in the Adiposity Patients Verlaufsbeobachtung (APV) registry. Patients were stratified with impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and Type 2 diabetes (T2D), according to American Diabetes Association criteria.
  
  
  RESULTS
  A total of 12.6% of the children presented with abnormal glucose metabolism (5.99% IFG, 5.51% IGT, 1.07% T2D). Body mass index (BMI) correlated modestly with 2-h blood glucose (r=0.04, P<0.001).In the 1008 patients with follow-up oGTT, metabolic parameters improved and the percentage of abnormal glucose metabolism decreased from 18.7 to 14.2%. Of the children with initial IGT, 70.6% converted to normal glucose tolerance. The improvement in oGTT results was associated with, but not dependent on, a reduction of BMI s.d. score.
  
  
  CONCLUSIONS
  In summary, we provide evidence for significant improvement of oGTT parameters in obese children treated in specialized treatment centers, even though reduction in BMI was modest.
authors.affiliation: Center for Pediatric Research, Department of Women and Child Health, University Hospital for Children & Adolescents, University of Leipzig, Leipzig, Germany. antje.koerner@medizin.uni-leipzig.de
authors.forename: A
authors.initials: A
authors.lastname: Körner
authors.forename: S
authors.initials: S
authors.lastname: Wiegand
authors.forename: A
authors.initials: A
authors.lastname: Hungele
authors.forename: S
authors.initials: S
authors.lastname: Tuschy
authors.forename: K P
authors.initials: KP
authors.lastname: Otto
authors.forename: D
authors.initials: D
authors.lastname: l'Allemand-Jander
authors.forename: K
authors.initials: K
authors.lastname: Widhalm
authors.forename: W
authors.initials: W
authors.lastname: Kiess
authors.forename: R W
authors.initials: RW
authors.lastname: Holl
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000378:metabolism*; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000378:metabolism / Q000517:prevention & control*; D002648:Child; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000378:metabolism* / Q000517:prevention & control; D005260:Female; D005858:Germany / Q000453:epidemiology; D018149:Glucose Intolerance; D005951:Glucose Tolerance Test; D006801:Humans; D007333:Insulin Resistance; D008137:Longitudinal Studies; D008297:Male; D010349:Patient Compliance; D063766:Pediatric Obesity / Q000453:epidemiology / Q000378:metabolism* / Q000517:prevention & control; D015995:Prevalence; D012042:Registries; D015431:Weight Loss
chemical_list: D001786:Blood Glucose