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High-normal fasting glucose levels are associated with increased prevalence of impaired glucose tolerance in obese children

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Abstract

The natural history of impaired glucose tolerance (IGT) and Type 2 diabetes among obese children is not clear. Although the cut-off for impaired fasting glucose (IFG) has recently been changed from 110 (6.1 mmol/l) to 100 mg/dl (5.6 mmol/l), it does not seem a reliable way to find all subjects with impaired glucose homeostasis. The aim of our study was to determine whether high-normal fasting glucose level could predict the occurrence of IGT and metabolic syndrome. Three hundred and twenty-three Italian obese children and adolescents were included in the study (176 females, mean age 11±2.9 yr; mean body mass index z-score: 3±0.6). Waist circumference, serum glucose, insulin, triglyceride, cholesterol HDL, blood pressure were evaluated and an oral glucose tolerance test (OGTT) was performed. The prevalence of IFG and IGT were respectively 1.5% (5 subjects) and 5% (18 patients); no diabetic patients were found. Metabolic syndrome was diagnosed in 20% of patients. Fasting glycemia values <100 mg/dl (5.6 mmol/l) have been divided in quintiles. Metabolic syndrome prevalence increased across quintiles, although not in a statistically significantly manner, but it could depend on the selected diagnostic criteria as no univocal definition exists for metabolic syndrome in youths. Interestingly high-normal fasting plasma glucose levels constitute an independent risk factor for IGT among obese children and adolescents; therefore, this very easy-to-use parameter may help to identify obese patients at increased risk of diabetes or at least could suggest in which subjects to perform an OGTT.

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Authors and Affiliations

  1. Dipartimento di Pediatria, Seconda Universitá di Napoli, Via Luigi De Crecchio 2, 80138, Napoli, Italy

    A. Grandone, A. Amato, C. Luongo, N. Santoro, L. Perrone & E. Miraglia del Giudice

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  1. A. Grandone
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  2. A. Amato
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  3. C. Luongo
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  4. N. Santoro
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  5. L. Perrone
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  6. E. Miraglia del Giudice
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Correspondence to E. Miraglia del Giudice.

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Grandone, A., Amato, A., Luongo, C. et al. High-normal fasting glucose levels are associated with increased prevalence of impaired glucose tolerance in obese children. J Endocrinol Invest 31, 1098–1102 (2008). https://doi.org/10.1007/BF03345659

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