title: Insulin dynamics and biochemical markers for predicting impaired glucose tolerance in obese Thai youth.
abstract: BACKGROUND
  Subjects with impaired glucose tolerance (IGT) are at risk for type 2 diabetes mellitus (T2DM) and cardiovascular disease. The predictors of IGT in obese youth are not well described.
  
  
  METHODS
  We studied 115 obese Thai children who underwent an oral glucose tolerance test (OGTT). Plasma glucose and insulin levels were calculated for assessment of β-cell function. Hemoglobin A1c (HbA1c), lipid profile, and clinical parameters were also used to determine predictors of IGT.
  
  
  RESULTS
  We found that three patients had T2DM and 30 subjects had IGT. IGT patients had significantly higher fasting glucose (FG), 1-h postload glucose, 2-h postload insulin, and lower whole-body insulin sensitivity indices than in normal glucose tolerance subjects whereas other indices were comparable. By ROC curve analyses, 1-h postload glucose was the best predictor of IGT, but FG or HbA1c represented a poor diagnostic tool for prediabetes screening. Subjects with 1-h OGTT glucose > 155 mg/dL had significantly lower high-density lipoprotein levels, lower insulin sensitivity, and more insulin resistance than those with 1-h postload glucose of ≤ 155 mg/dL.
  
  
  CONCLUSIONS
  Abnormal glucose tolerance is highly prevalent in obese Thai youth. Several fasting indices and HbA1c fail to predict IGT. An 1-h OGTT glucose of > 155 mg/dL appears to be more associated with adverse insulin dynamics and metabolic profile than 2-h postload glucose.
authors.forename: Sirapassorn
authors.initials: S
authors.lastname: Tirabanchasak
authors.forename: Sukumarn
authors.initials: S
authors.lastname: Siripunthana
authors.forename: Vichit
authors.initials: V
authors.lastname: Supornsilchai
authors.forename: Suttipong
authors.initials: S
authors.lastname: Wacharasindhu
authors.forename: Taninee
authors.initials: T
authors.lastname: Sahakitrungruang
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism*; D002648:Child; D005260:Female; D018149:Glucose Intolerance / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D007328:Insulin / Q000097:blood*; D007333:Insulin Resistance / Q000502:physiology; D008055:Lipids / Q000097:blood; D008297:Male; D009765:Obesity / Q000097:blood* / Q000150:complications; D013785:Thailand
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007328:Insulin; D008055:Lipids