糖化血红蛋白诊断肥胖儿童糖尿病前期阈值的探究

目的 探究糖化血红蛋白(HbA1c)诊断肥胖儿童糖尿病前期的最佳阈值,以期为我国肥胖儿童HbA1c诊断糖尿病前期的开展提供参考.方法 本研究为回顾性样本的横断面研究.选取2018年6月-2021年5月在宁波市妇女儿童医院内分泌科住院部诊断为肥胖的儿童191例,均于空腹8 h后行口服葡萄糖耐量试验(OGTT),记录空腹血...

Exploration of HbA1c threshold for the diagnosis of prediabetes in obese children

Objective To explore the optimal threshold of HbA1c in the diagnosis of prediabetes in obese children, in order to provide reference for HbA1c in the diagnosis of prediabetes in obese children in China. Methods A retrospective cross-sectional study was conducted.Totally 191 obese children diagnosed in the Department of Endocrinology, Ningbo Women and Children's Hospital were enrolled in this study from June 2018 to May 2021.Oral glucose tolerance test (OGTT) was performed 8 hours after fasting, and fasting blood glucose (FPG) and 2 h post load blood glucose (2 h PG), and HbA1c were tested.According to the diagnostic criteria of the American Diabetes Association in 2020, the participants were divided into the non-prediabetes group and the prediabetes group.The level of HbA1c was compared between the two groups, and ROC curve of HbA1c for the diagnosis of prediabetes was drawn.The diagnosis value of area under curve (AUC) and the sensitivity and specificity of different thresholds were calculated, so as to reveal the optimal threshold for diagnosis. Results According to the OGTT results, children diagnosed with diabetes were excluded, then the participants were divided into two groups, with 142 in the non-prediabetes group (77.6%) and 41 in the prediabetes group (22.4%).After correcting confounding factors by propensity score matching, 100 patients were included in the model, including 63 in the non-prediabetes group and 37 in the prediabetes group.The level of HbA1c of children in non-prediabetes group [(5.52±0.34)%] was significantly lower than that in prediabetes group[(5.69±0.39)%] (t=2.247,P=0.027).ROC curve indicated that area under the curve (AUC) of HbA1c in predicting prediabetes was 0.625 with the optimal threshold of 5.45%, the corresponding sensitivity and specificity was 73.0% and 66.7%, respectively. Conclusion It is speculated that the optimal threshold value of HbA1c for the diagnosis of prediabetes in obese children is 5.45%.