Background: Current guidelines suggest to test obese subjects with impaired fasting glucose (IFG) by oral glucose tolerance test (OGTT) for the presence of type 2 diabetes. This strategy, however, misses most cases of impaired glucose tolerance (IGT).
Objective and hypotheses: To investigate whether combining risk factors improves predictability of IGT in OGTT.
Method: In this observational study of 145 overweight children, aged 2.517.3 years, an OGTT was performed in all obese subjects. We determined the association of anthropometric and laboratory parameters with IGT. Furthermore, we analysed whether a combined model of associated parameters improved sensitivity of screening for IGT.
Results: Out of 145 patients (53% female, 66% Caucasian, mean age 11.3 years, mean BMI SDS 3.4) IGT was present in 11 patients, of whom 2 had IFG. Hypertension (P=0.025) and elevated liver enzymes (P=0.003) were associated with IGT, whereas IFG was not (P=0.067). The presence of one or more abnormal screening parameters predicted IGT with a high sensitivity of 1.00 (95% CI 0.741.00), and a number needed to screen of 5.7.
Conclusion: Combining IFG, presence of hypertension and elevated liver enzymes, into a model significantly increases predictability of IGT compared to using IFG alone.
10 - 12 Sep 2016
European Society for Paediatric Endocrinology