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1-Hour plasma glucose in obese youth

Authors
  • Manco, M.1
  • Miraglia Del Giudice, E.2
  • Spreghini, M. R.3
  • Cappa, M.4
  • Perrone, L.2
  • Brufani, C.4
  • Rustico, C.3
  • Morino, G.3
  • Caprio, S.5
  • 1 Ospedale Pediatrico Bambino Gesù, Istituto di Ricovero e Cura a Carattere Scientifico, Piazza SanOnofrio 4, Rome, I-00165, Italy , Rome (Italy)
  • 2 “F. Fede”, Seconda Università degli Studi di Napoli, Dipartimento di Pediatria, Naples, Italy , Naples (Italy)
  • 3 Ospedale Pediatrico Bambino Gesù, Unità di Dietologia Clinica, Rome, Italy , Rome (Italy)
  • 4 Ospedale Pediatrico Bambino Gesù, Unità di Endocrinologia, Rome, Italy , Rome (Italy)
  • 5 Yale University School of Medicine, Department of Pediatrics, New Haven, CT, USA , New Haven (United States)
Type
Published Article
Journal
Acta Diabetologica
Publisher
Springer Milan
Publication Date
Mar 06, 2012
Volume
49
Issue
6
Pages
435–443
Identifiers
DOI: 10.1007/s00592-012-0384-3
Source
Springer Nature
Keywords
License
Yellow

Abstract

Adults with normal glucose tolerance (NGT) but exaggerated plasma glucose excursion at 1 h (1HPG) following the oral glucose tolerance test (OGTT) have significantly higher risk of developing impaired glucose tolerance (IGT) or diabetes. Aim of the study will be to characterize the metabolic phenotype of NGT obese youth according to values of 1HPG. To accomplish this aim, obese patients (N = 1,454; 761 men; 79 IGT; BMI z-score 2.56 ± 0.16 SDS; age 11 ± 0.7 years) from two data sets were analyzed. In all patients, empirical parameters of insulin metabolism were calculated in fasting condition and following an OGTT (1.75 mg of glucose per kilogram/body weight). Receiver-operating characteristic (ROC) analysis was performed in the first group (training set, N = 920) to establish the cutoff value of 1HPG best identifying IGT. The second set (validation set, N = 534) served to verify the goodness of the model and the identified cutoff values. 1HPG ≥ 132.5 mg/dl identified IGT with 80.8% sensitivity and 74.3% specificity in the training set (AUC 0.855, 95% CI 0.808–0.902, p < 0.0001), and 70.3% sensitivity and 80% specificity in the validation set (AUC 0.81, 95% CI 0.713–0.907, p < 0.0001), respectively. NGT patients with 1HPG ≥ 132.5 mg/dl had a metabolic phenotype (triglycerides, insulin action, and secretion) that was in between those of NGT patients with 1HPG below the threshold and IGT patients (p < 0.0001 for all the comparisons). 1HPG ≥ 132.5 mg/dl seems to be associated with increased metabolic risk in obese youth, identifying patients with lower insulin sensitivity, early secretion, and higher total insulin secretion than in obese mates with lower 1HPG.

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