Introduction: The identification of obese patients with increased susceptibility and risk for glucose intolerance and type 2 diabetes requires an oral glucose tolerance test (OGTT). Reference values for Body mass index (BMI) and Tri-Ponderal mass index (TMI) according to age and sex of healthy children in Spain without malnutrition or obesity have recently been published (*). TMI values remain very uniform in both boys and girls from the age of 8 to 18 years, therefore a single cut-off point is optimal to identify overweight (TMI≥ 13.8 and ≤ 15.2) and obesity (TMI ≥ 15.3).
Objectives: To determine the prevalence of glucose intolerance and Type 2 diabetes in a cohort of obese children and adolescents and to establish the predictive value of the Tri-Ponderal mass index (TMI) and other anthropometric parameters to identify these comorbidities.
Patients and Methods: Cross-sectional study of 239 obese patients (125 males) aged 8 to 18 years (12.5 ± 2.3). 45.9% of which have grade 3 obesity. ROC curves were used to find the best cut-off point for: TMI (kg/m3), BMI (kg/m2), BMI z-score value (zsBMI) and waist-to-height ratio (WHtR) to identify patients with glucose intolerance or type 2 diabetes according to American Diabetes Association criteria.
Results: The prevalence of glucose intolerance and type 2 diabetes in this cohort is 9% (10 males and 12 females) and 0% respectively, with no differences observed in relation to sex and age.
|ROC Area||Sensitivity||Specificity||Correctly classified||Cut -off point (Youden)||Best Cut off point (AUC)|
Conclusion: The diagnostic accuracy of IMT for identifying obese children and adolescents aged 8 to 18 years with impaired glucose tolerance is superior to the other anthropometric parameters evaluated and allows correct classification of 83.2% of patients. Obese patients with IMT > 21.5 should be considered for OGTT.
22 Sep 2021 - 26 Sep 2021