Utility of hemoglobin A1c to screen for impaired glucose tolerance
Abstract
Background Childhood obesity is associated with an increased
likelihood for having impaired glucose tolerance, dyslipidemia,
and diabetes. Hemoglobin Ale (HbAl c) h as emerged as a
recommended diagnostic tool for identifying diabetes and persons
at risk for the disease. This recommendation was based on data
in adults, showing the relationship between HbAl C and the
future development of diabetes . However, studies in the pediatric
population have been limited and no stan dard values of HbAlc
levels in children have been established.
Objective To evaluate HbAlc as a test for impaired glucose
tolerance in obese children and adolescents and to identify the
optimal HbAlc thresh old level (cut off poin t).
Methods We studied 65 obese and 4 overweight children (BMI 2::
+ 2 SD for age and gender) aged 10-15 years in Palembang. All
subjects underwent HbAlc and oral glucose tolerance tests.
Results Nineteen out of 69 subjects (28%) had impaired glucose
tolerance. Based on the receiver operating characteristic curve,
the optimal cut off point of HbAlc related to impaired glucose
tolerance as diagnosed by oral glucose tolerance test was found to
be 5.25%, with 63% sensitivity and 64% specificity, 40% positive
predictive value, and 82% negative predictive value. The area
under the receiver operating ch aracteristic curve was O .68 7
(95%CI 0.541-0.833; P < 0.00 1).
Conclusion A HbAlc cut off value of 5.25% may be used as a
screening tool to identify children and adolescents with impaired
glucose tolerance.
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Accepted 2016-09-16
Published 2014-08-31
