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A new formula to improve the screening of impaired glucose tolerance in youths with overweight or obesity

Institution:	1. Department of Internal Medicine, “S. Maria delle Grazie” Hospital, Pozzuoli, Italy;2. Obesity and Endocrine Disease Unit, Department of Neuroscience, Santobono-Pausilipon Children''s Hospital, Napoli, Italy;3. Department of Human Pathology in Adulthood and Childhood, University of Messina, Messina, Italy;4. Department of Woman, Child and of General and Specialized Surgery, Università degli Studi della Campania “Luigi Vanvitelli”, Napoli, Italy;5. Department of Surgery, Dentistry, Pediatrics and Gynecology, Section of Pediatric Diabetes and Metabolism, University and Azienda Ospedaliera Universitaria Integrata of Verona, Italy;6. Department of Biomedical Sciences and Human Oncology, Pediatric Unit, University of Bari “Aldo Moro”, Bari, Italy;7. Section of Pediatrics, Department of Translational Medical Science, Regional Center of Pediatric Diabetes, University of Naples Federico II, Napoli, Italy;8. Pediatric Department, “V. Buzzi” Children’s Hospital, Milano and Department of Internal Medicine, University of Pavia, Italy;9. Pediatric Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy;10. Pediatric Department, Azienda Sanitaria Universitaria del Friuli Centrale, Hospital of Udine, Udine, Italy;11. Department of Movement Sciences and Wellbeing, University “Parthenope”, Napoli, Italy;1. Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore;2. Université de Paris, CRESS, Inserm, INRAE, F-75004 Paris, France;3. Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore;4. Department of Maternal Fetal Medicine, KK Women''s and Children''s Hospital, Singapore;5. Department of Paediatric Endocrinology, KK Women''s and Children''s Hospital, Singapore;6. Duke-NUS Medical School, Singapore;7. Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore;8. Liggins Institute, University of Auckland, New Zealand;9. MRC Lifecourse Epidemiology Unit & NIHR Southampton Biomedical Research Centre, University of Southampton & University Hospital Southampton NHS Foundation Trust, UK;10. Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore;11. Department of Reproductive Medicine, KK Women''s and Children''s Hospital, Singapore;12. Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore;1. Department of Medical Biochemistry, University of Belgrade – Faculty of Pharmacy, Belgrade, Serbia;2. Department of Laboratory Diagnostics, University Medical Center “Be?anijska kosa”, Belgrade, Serbia;3. Department of Cardiology, University Medical Center “Be?anijska kosa” and University of Belgrade-Faculty of Medicine, Belgrade, Serbia;4. Department of Pulmonology, University Medical Center “Be?anijska kosa”, Belgrade, Serbia;1. Department of Geriatric Medicine, Center of Coronary Circulation, Xiangya Hospital, Central South University, Changsha, 410008, China;2. National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008, China;3. Department of Cardiovascular Medicine, Xiangya Hospital, Central South University, Changsha, 410008, China;4. Department of Cardiovascular Medicine, The Third Xiangya Hospital, Central South University, Changsha, 410013, China;1. Diabetes and Islet Transplantation Unit, Department of Diagnostic and Therapeutic Services, IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), UPMC (University of Pittsburgh Medical Center), Palermo, Italy;2. Department of Internal Medicine, National Relevance and High Specialization Hospital Trust ARNAS Civico, Di Cristina, Benfratelli, Palermo, Italy;3. Dipartimento di Promozione Della Salute, Materno Infantile, Medicina Interna e Specialistica di Eccellenza “G. D''Alessandro”, PROMISE, University of Palermo, Palermo, Italy;1. Department of Endocrinology, Diabetology and Nutrition, Faculty of Medicine, University of Constantine 3, Algeria;2. Preventive Medicine of Chronic Diseases Research Laboratory, University of Constantine 3, Algeria;3. Unit of Endocrinology-Diabetology-Nutrition, Jean Verdier Hospital, APHP, Paris 13 University, Sorbonne Paris Cité, CINFO, CRNH-IdF, Bondy, France;4. FEMTO-ST Institute, Univ. Bourgogne Franche-Comté, CNRS, ENSMM, France;1. Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran, Iran;2. Department of Community Medicine, Tehran University of Medical Sciences, Tehran, Iran

Abstract:	AimTo assess a new formula to improve the screening of isolated impaired glucose tolerance (IGT) in youth with overweight/obesity (OW/OB).Methods and resultsA cross-sectional study was performed in 1189 Caucasian youths with OW/OB aged 5–17 years, in whom impaired fasting glucose and high glycosylated hemoglobin were excluded. The sample was divided into training set (TS) (n = 883) and validation set (VS) (n = 306). Fasting (FG) and post-load plasma glucose, alanine aminotransferase (ALT), lipids and familial history for type 2 diabetes (FD) were available in all individuals. In the TS youths with IGT (n = 58, 7.0%) showed higher prevalence of female sex (FS), FD, and higher levels of FG, post-load glucose, ALT and lower levels of HDL-cholesterol vs individuals without IGT. The linear formula was obtained by logistic regression analysis in the TS: 0.051ALT + 0.071FG + 0.871FD + (0.061HDL1 ? 1) + 11FS. The best cut-off was 5.84. The performance of the formula vs IGT was: sensitivity: 0.74 and specificity: 0.71. Similar results were obtained in the VS.ConclusionsUsing metabolic and anamnestic data we obtained a simple formula with a good performance for screening isolated IGT. This formula may support pediatricians to identify youths with OW/OB in whom the OGTT may be useful for detecting IGT.

Keywords:	Impaired glucose tolerance Pediatric obesity Screening Prediabetes ADA"} {"#name":"keyword" "$":{"id":"kwrd0035"} "$$":[{"#name":"text" "_":"American Diabetes Association ALT"} {"#name":"keyword" "$":{"id":"kwrd0045"} "$$":[{"#name":"text" "_":"Alanine-aminotransferase AUC"} {"#name":"keyword" "$":{"id":"kwrd0055"} "$$":[{"#name":"text" "_":"area under curve BMI"} {"#name":"keyword" "$":{"id":"kwrd0065"} "$$":[{"#name":"text" "_":"Body mass index FD"} {"#name":"keyword" "$":{"id":"kwrd0075"} "$$":[{"#name":"text" "_":"Familial diabetes FS"} {"#name":"keyword" "$":{"id":"kwrd0085"} "$$":[{"#name":"text" "_":"female sex IFG"} {"#name":"keyword" "$":{"id":"kwrd0095"} "$$":[{"#name":"text" "_":"impaired fasting glucose IGT"} {"#name":"keyword" "$":{"id":"kwrd0105"} "$$":[{"#name":"text" "_":"impaired glucose tolerance HbA1c"} {"#name":"keyword" "$":{"id":"kwrd0115"} "$$":[{"#name":"text" "_":"glycosilated hemoglobin 1 c HDL-c"} {"#name":"keyword" "$":{"id":"kwrd0125"} "$$":[{"#name":"text" "_":"High density lipoprotein-cholesterol OB"} {"#name":"keyword" "$":{"id":"kwrd0135"} "$$":[{"#name":"text" "_":"obesity OGTT"} {"#name":"keyword" "$":{"id":"kwrd0145"} "$$":[{"#name":"text" "_":"oral glucose tolerance test OW"} {"#name":"keyword" "$":{"id":"kwrd0155"} "$$":[{"#name":"text" "_":"overweight SDS"} {"#name":"keyword" "$":{"id":"kwrd0165"} "$$":[{"#name":"text" "_":"standard deviation score TG"} {"#name":"keyword" "$":{"id":"kwrd0175"} "$$":[{"#name":"text" "_":"triglycerides TS"} {"#name":"keyword" "$":{"id":"kwrd0185"} "$$":[{"#name":"text" "_":"training set VS"} {"#name":"keyword" "$":{"id":"kwrd0195"} "$$":[{"#name":"text" "_":"validation set
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