ESPE Abstracts

Background: Prediabetes often precedes type 2 diabetes, which is associated with obesity and increased risk of developing cardiovascular disease. Haemoglobin A1c (HbA1c) has been recently recommended as a useful tool for the diagnosis of diabetes and prediabetes.

Objective and hypotheses: We investigated whether prediabetes according to HbA1c was associated with cardiometabolic risk factors in Korean children and adolescents.

Method: We used data from the 2011–2012 Korean National Health and Nutrition Examination Survey (KNHANES), which is the nationally representative database. In total, 1 581 subjects aged 10–19 years were assessed. We classified the subjects into two groups based on HbA1c level (the normoglycaemia group with HbA1c of <5.7%; the prediabetes group with HbA1c of 5.7–6.4%). Clinical characteristics and cardiometabolic risk factors between the normoglycaemia and prediabetes groups were compared.

Results: According to HbA1c levels, 305 subjects (171 boys and 134 girls) had prediabetes. In the prediabetes group, obesity, waist circumference (WC), WC to height ratio (WHtR), total cholesterol, triglyceride (TG), fasting glucose, AST and ALT were significantly higher than those in the normoglycaemia group (P<0.001). Metabolic syndrome by IDF definition was 3.5% in prediabetes group and 1.4% in the normoglylcaemia group (statistically non-significant, P=0.098). In the both normoglylcaemia and prediabetes groups, overweight/obese subjects had higher BMI, WC, WHtR, blood pressure, TG, AST and ALT (P<0.05) and lower HDL cholesterol (P<0.001) than those with normal weight. Age-, sex- and income-adjusted logistic regression analysis showed that the subjects with prediabetes had increased risk of having obesity (OR 1.52, P<0.001), abdominal obesity (OR 2.75, P<0.001), hypertriglyceridemia (OR 2.02, P=0.005), high ALT (OR 2.53, P<0.001).

Conclusion: Prediabetic HbA1c levels in Korean children and adolescents were strongly associated with increased cardiometabolic risk factors. HbA1c might be a useful marker to assess cardiometabolic risk in children and adolescents.