Pediatric diabetes · 2018
Two- vs one-hour glucose tolerance testing: Predicting prediabetes in adolescent girls with obesity.
СтатьяРандомизированное исследованиеПоддержка NIH: внешняя программаНазвание и аннотация: Перевод пока не подготовлен
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Kasturi Kannan, Onuzuruike Anthony U, Kunnam Shwetha, Shomaker Lauren B, Yanovski Jack A, Chung Stephanie T
Аннотация
BACKGROUND: During an oral glucose tolerance test (OGTT), morphological features of the glucose curve (monophasic curve, glucose peak >30 minutes and 1-hour glucose ≥ 155 mg/dL) maybe associated with higher prediabetes risk, but their reproducibility and predictive ability in adolescents with obesity are unknown.
METHODS: Nondiabetic adolescent girls with obesity underwent a multiple-sample OGTT at baseline (n = 93), 6 weeks (n = 83), and 1 year (n = 72). Short-term reproducibility (baseline to 6 weeks) and the predictive ability for prediabetes (baseline to 1 year) for each feature were compared with standard fasting and 2-hour OGTT diagnostic criteria.
RESULTS: There was fair/moderate short-term reproducibility (κ < 0.5) for all morphological features. At 1 year, compared with standard OGTT criteria, the areas under the receiver operating curve (ROC-AUCs) for glucose peak > 30 minutes, 1 hour ≥155 mg/dL or a combination of the two criteria were comparable (all P > 0.05), but the monophasic curve had the lowest ROC-AUC (P < 0.001).
CONCLUSIONS: In adolescent girls with obesity, glucose peak > 30 minutes and/or glucose ≥155 mg/dL had similar reproducibility and 1-year predictive ability for prediabetes compared with standard OGTT criteria. The shortened 1-hour OGTT may provide diagnostic equivalence for prediabetes risk with the additional advantage of a less time-consuming risk assessment.
METHODS: Nondiabetic adolescent girls with obesity underwent a multiple-sample OGTT at baseline (n = 93), 6 weeks (n = 83), and 1 year (n = 72). Short-term reproducibility (baseline to 6 weeks) and the predictive ability for prediabetes (baseline to 1 year) for each feature were compared with standard fasting and 2-hour OGTT diagnostic criteria.
RESULTS: There was fair/moderate short-term reproducibility (κ < 0.5) for all morphological features. At 1 year, compared with standard OGTT criteria, the areas under the receiver operating curve (ROC-AUCs) for glucose peak > 30 minutes, 1 hour ≥155 mg/dL or a combination of the two criteria were comparable (all P > 0.05), but the monophasic curve had the lowest ROC-AUC (P < 0.001).
CONCLUSIONS: In adolescent girls with obesity, glucose peak > 30 minutes and/or glucose ≥155 mg/dL had similar reproducibility and 1-year predictive ability for prediabetes compared with standard OGTT criteria. The shortened 1-hour OGTT may provide diagnostic equivalence for prediabetes risk with the additional advantage of a less time-consuming risk assessment.