Background: The prevalence of dysglycaemia is high among overweight children and adolescents. Current screening criteria with fasting laboratory values have low sensitivity to detect IGT. Fasting triglycerides (TG) >1.17 mmol/l has been proposed as a criterion for screening obese children and adolescents at risk for IGT.
Aims and objectives: We aimed to compare the performance of different screening criteria for detecting IGT in obese and overweight children and adolescents.
Methods: We studied a cohort of 307 Caucasian obese and overweight children and adolescents (age 11.4±3.2, range 318; 46% males, BMI 27.9±4.7, and range 20.447.6) who consecutively underwent clinical evaluation, fasting blood analysis, and oral glucose tolerance test (OGTT) in our Pediatric Endocrinology Unit from July 2011 to March 2013. We compared the discriminative properties of fasting glycaemia, TG, HDL, insulinaemia, HOMA index, HbA1c, and triglycerides:HDL (TG:HDL) ratio for the detection of IGT. The association of these variables with IGT was assessed by logistic analysis and by receiving operating characteristics (ROC).
Results: After OGTT, 23 children (6.9%) presented an IGT. The 1.17 mmol/l TG threshold showed a 45% sensitivity and 83% specificity in detecting IGT. In logistic analysis, HDL and TG:HDL were the only variables significantly associated with IGT (HDL, P=0.034 and TG:HDL, P=0.043). TG:HDL presented the best area under the ROC (TG 0.658, TG:HDL 0.668, glycaemia 0.522, insulinaemia 0.539, HOMA 0.524, HbA1c 0.566, and HDL 0.624). The 0.8 threshold for TG:HDL presented the highest sensitivity (70%) and specificity (59.5%) in detecting IGT.
Conclusions: The TG:HDL ratio presented the best predictive value for IGT screening in our cohort of overweight paediatric patients, while other fasting laboratory values presented a poor performance.
01 Oct 2015 - 03 Oct 2015