Comparison of A1C to Oral Glucose Tolerance Test for the Diagnosis of Prediabetes in Overweight and Obese Youth

Khokhar, Aditi; Naraparaju, Gayathri; Friedman, Maureen G.; Perez-Colon, Sheila; Umpaichitra, Vatcharapan; Chin, Vivian

doi:10.2337/cd16-0037

Cited by 10 publications

(10 citation statements)

References 40 publications

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“…Studies using adult cutoff values suggested an underestimation of the prevalence of diabetes and prediabetes [37,39]. Recently, Khokhar et al [40] found that HbA1c alone is a poor differentiator of prediabetes in a group of obese Caribbean and African-American children. Hence, it remains unclear if HbA1C and the same cutoff value should be used in children [3,37,38].…”

Section: Discussionmentioning

confidence: 99%

Abnormal glucose tolerance in children: oral glucose tolerance test is fit-for-purpose

Law

Young

et al. 2023

Exploration of Medicine

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Aim: Childhood obesity is accompanied by an increased prevalence of abnormal glucose tolerance (AGT) including the prediabetes states. This study aims to investigate and evaluate the use of oral glucose tolerance test (OGTT) for detecting AGT among overweight and obese children. Methods: A retrospective study was conducted on 895 overweight and obese Chinese children (6–18 years) with obesity assessment and analysis of demographic, anthropometric, and biochemical parameters data between January 2006 and December 2015 at Tseung Kwan O Hospital, Hong Kong Special Administrative Region. Results: The proportion of males and older age group was 63.7% and 55.9%, respectively. Girls were more in older age groups (62.7% vs. 52.0%, P = 0.002). AGT occurred in 17.1% of the cohort [impaired glucose tolerance (IGT) was the most frequent morbidity (11.3%)]. After regression analysis, female sex, low-density lipoprotein (LDL), triglyceride (TG), older age group, and homeostasis model assessment of insulin resistance (HOMA-IR) ≥ 4.1 were significantly associated with AGT. Conclusions: AGT is common in overweight and obese Chinese children. Girls, older age, higher LDL, TG and HOMA-IR ≥ 4.1 showed significant association with AGT. OGTT is essential and fit-for-purpose to detect AGT in overweight and obese children.

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Section: Discussionmentioning

confidence: 99%

Abnormal glucose tolerance in children: oral glucose tolerance test is fit-for-purpose

Law

Young

et al. 2023

Exploration of Medicine

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“…Therefore, pre-diabetes is a necessary stage for diabetic patients. The early diagnosis of diabetes is an important way to reduce morbidity, complications, and mortality, and has important significance for the clinical evaluation and prevention of diabetes (Cefalu et al, 2014;Yi et al, 2014;Huang et al, 2016;Khokhar et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

Early Diagnosis of Type 2 Diabetes Based on Near-Infrared Spectroscopy Combined With Machine Learning and Aquaphotomics

Guo²,

et al. 2020

Front. Chem.

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Early diagnosis is important to reduce the incidence and mortality rate of diabetes. The feasibility of early diagnosis of diabetes was studied via near-infrared spectra (NIRS) combined with a support vector machine (SVM) and aquaphotomics. Firstly, the NIRS of entire blood samples from the population of healthy, pre-diabetic, and diabetic patients were obtained. The spectral data of the entire spectra in the visible and near-infrared region (400–2,500 nm) were used as the research object of the qualitative analysis. Secondly, several preprocessing steps including multiple scattering correction, variable standardization, and first derivative and second derivative steps were performed and the best pretreatment method was selected. Finally, for the early diagnosis of diabetes, models were established using SVM. The first overtone of water (1,300–1,600 nm) was used as the research object for an aquaphotomics model, and the aquagram of the healthy group, pre-diabetes, and diabetes groups were drawn using 12 water absorption patterns for the early diagnosis of diabetes. The results of SVM showed that the highest accuracy was 97.22% and the specificity and sensitivity were 95.65 and 100%, respectively when the pretreatment method of the first derivative was used, and the best model parameters were c = 18.76 and g = 0.008583.The results of the aquaphotomics model showed clear differences in the 1,400–1,500 nm region, and the number of hydrogen bonds in water species (1,408, 1,416, 1,462, and 1,522 nm) was evidently correlated with the occurrence and development of diabetes. The number of hydrogen bonds was the smallest in the healthy group and the largest in the diabetes group. The suggested reason is that the water matrix of blood changes with the worsening of blood glucose metabolic dysfunction. The number of hydrogen bonds could be used as biomarkers for the early diagnosis of diabetes. The result show that it is effective and feasible to establish an accurate and rapid early diagnosis model of diabetes via NIRS combined with SVM and aquaphotomics.

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“…Khokhar et al [25] studied predominantly African American and Caribbean youth (n=230) and found that HbA1 c had a receiver operating curve of 0.64 (95% CI, 0.56–0.72), showing that HbA1 c had poor sensitivity for detecting prediabetes when compared to OGTT. While 56% of the cohort had an elevated HbA1 c , 26% had an abnormal OGTT result, with 18% testing positive for both HbA1 c and OGTT.…”

Section: How Do These Tests Do When Compared To Each Other?mentioning

confidence: 99%

Update on the current modalities used to screen high risk youth for prediabetes and/or type 2 diabetes mellitus

Brar

2019

Ann Pediatr Endocrinol Metab

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The modalities currently employed to screen for type 2 diabetes mellitus (T2DM)/ prediabetes are HbA1c, fasting plasma glucose (FPG), and 2-hour plasma glucose (PG) during an oral glucose tolerance test (OGTT). The purpose of this review is to highlight the positive qualities and pitfalls of these diagnostic modalities and reflect on the most reasonable and effective approach to screen high risk youth. Given its inherent preanalytical advantages, glycated hemoglobin (HbA1c) continues to be the preferred diagnostic modality used by pediatricians to screen high risk youth. However, when the three aforementioned tests are performed in youths of different races/ethnicities, discrepant results for T2DM/prediabetes are observed. The prevalence rates for T2DM vary from 0.53% in Chinese youth (including youth of all body mass indexes) to 18.3% in high-risk, overweight, obese Korean youth. Moreover, the FPG is abnormal (>100 less than <126 mg/dL) in 15% of Korean youth versus 8.7% of Chinese youth. The prevalence rates for prediabetes are 1.49% in Chinese youth versus 21% in Emirati youth (HbA1c, 5.7%-6.4%). The coefficient of agreement, k, between these screening tests for T2DM are fair, 0.45-0.5 across all youth. However, using HbA1c as a comparator, the agreement is weak with FPG (k=0.18 in German youth versus k=0.396 in Korean youth). The American Diabetes Association (ADA) Standards of Medical Care Guidelines define "high risk youth" who need to be tested for T2DM and/or prediabetes. OGTT and HbA1c do not always detect T2DM in similar individuals. HbA1c may not be an ideal test for screening Hispanic and African American youth. FPG and OGTT are suitable screening tests for youth of ethnic minorities and those with cystic fibrosis or hemoglobinopathies. Performing all three tests either together or sequentially may be the only way to encompass all youth who have aberrations in different aspects of glucose homeostasis.

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Comparison of A1C to Oral Glucose Tolerance Test for the Diagnosis of Prediabetes in Overweight and Obese Youth

Cited by 10 publications

References 40 publications

Abnormal glucose tolerance in children: oral glucose tolerance test is fit-for-purpose

Abnormal glucose tolerance in children: oral glucose tolerance test is fit-for-purpose

Early Diagnosis of Type 2 Diabetes Based on Near-Infrared Spectroscopy Combined With Machine Learning and Aquaphotomics

Update on the current modalities used to screen high risk youth for prediabetes and/or type 2 diabetes mellitus

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