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1-Hour plasma glucose in obese youth

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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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Abbreviations

AUC:

Area under the curve

GDI:

Glucose disposition index

HOMA-IR:

Homeostasis model assessment of insulin resistance

1HPG:

1-Hour plasma glucose

IFG:

Impaired fasting glucose

IGT:

Impaired glucose tolerance

IGI:

Insulino-genic index

NGT:

Normal glucose tolerance

OGTT:

Oral glucose tolerance test

WBISI:

Whole body insulin sensitivity index

ROC:

receiver-operating characteristic

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Acknowledgments

The work was supported by the Italian 5 × 1000 contribution 2007 and by a grant to MM from the Italian Ministry of Health (RF-OPG-20081142374). We are indebted to all children and adolescents who participated in the study.

Conflict of interest

None.

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Authors and Affiliations

  1. Istituto di Ricovero e Cura a Carattere Scientifico, Ospedale Pediatrico Bambino Gesù, Piazza SanOnofrio 4, I-00165, Rome, Italy

    M. Manco

  2. Dipartimento di Pediatria, “F. Fede”, Seconda Università degli Studi di Napoli, Naples, Italy

    E. Miraglia Del Giudice & L. Perrone

  3. Unità di Dietologia Clinica, Ospedale Pediatrico Bambino Gesù, Rome, Italy

    M. R. Spreghini, C. Rustico & G. Morino

  4. Unità di Endocrinologia, Ospedale Pediatrico Bambino Gesù, Rome, Italy

    M. Cappa & C. Brufani

  5. Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA

    S. Caprio

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  1. M. Manco
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  2. E. Miraglia Del Giudice
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  3. M. R. Spreghini
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  4. M. Cappa
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  5. L. Perrone
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  6. C. Brufani
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  7. C. Rustico
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  8. G. Morino
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  9. S. Caprio
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Corresponding author

Correspondence to M. Manco.

Additional information

Communicated by Antonio Secchi.

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Manco, M., Miraglia Del Giudice, E., Spreghini, M.R. et al. 1-Hour plasma glucose in obese youth. Acta Diabetol 49, 435–443 (2012). https://doi.org/10.1007/s00592-012-0384-3

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  • DOI: https://doi.org/10.1007/s00592-012-0384-3

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