Abstract | UNLABELLED: OBJECTIVES: We aimed to validate fasting triglycerides > 1.17 mmol L(-1) , a criterion recently proposed for selecting obese children at risk of impaired glucose tolerance (IGT), and to assess whether the accuracy of triglycerides (TG) can be improved by the use of other variables. METHODS: We studied an Italian cohort of 817 obese children and adolescents (8-18.4 years) who underwent clinical examination, fasting blood analysis and the oral glucose tolerance test (OGTT). The discriminative properties of TG > 1.17 mmol L(-1) were assessed and compared with those observed in a Canadian cohort from which this criterion was derived: 71.4 [57.8-85.1]% sensitivity and 64.1 [57.7-70.4]% specificity. The possible contribution of other variables was evaluated by assessing the net reclassification improvement (NRI), i.e., the net increase in the percentage of subjects correctly classified. RESULTS: Thirty-nine children (4.7%) had IGT. The 1.17 mmol L(-1) TG threshold showed 66.6 [51.8-81.4]% sensitivity and 68.2 [64.9-71.5]% specificity, thus successfully validated. Fasting plasma glucose (FPG) was independently associated with IGT (odds ratio = 3.86 [2.09-7.14], P < 0.001), besides TG. The bivariate criterion of TG ≥ 1.13 mmol L(-1) plus FPG ≥ 4.44 mmol L(-1) had a 69.2 [54.7-83.7]% sensitivity and a 78.2 [76.8-79.6]% specificity, thus displaying a 12.6% NRI (P < 0.001) compared with TG>1.17 mmol L(-1) . CONCLUSIONS: TG > 1.17 mmol L(-1) is a useful criterion to detect roughly 66% of obese children with IGT through OGTT performed in about 33% of all obese children. However, the 'TG≥1.13 mmol L(-1) plus FPG≥4.44 mmol L(-1) ' criterion improved discrimination accuracy, leading to the possibility of detecting even more than 66% of obese children with IGT though limiting OGTT to just 25% of all obese children.
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Authors | A Morandi, M Maschio, M Marigliano, E Miraglia Del Giudice, B Moro, P Peverelli, C Maffeis |
Journal | Pediatric obesity
(Pediatr Obes)
Vol. 9
Issue 1
Pg. 17-25
(Feb 2014)
ISSN: 2047-6310 [Electronic] England |
PMID | 23296488
(Publication Type: Journal Article, Validation Study)
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Copyright | © 2013 The Authors. Pediatric Obesity © 2013 International Association for the Study of Obesity. |
Chemical References |
- Blood Glucose
- Triglycerides
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Topics |
- Adolescent
- Blood Glucose
(metabolism)
- Body Mass Index
- Child
- Diabetes Mellitus, Type 2
(prevention & control)
- Fasting
- Female
- Glucose Intolerance
(blood, epidemiology, etiology)
- Glucose Tolerance Test
- Humans
- Italy
(epidemiology)
- Male
- Mass Screening
- Obesity
(blood, complications)
- Prevalence
- Risk Assessment
- Triglycerides
(blood)
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