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Pediatr Diabetes. 2017 Dec;18(8):734-741. doi: 10.1111/pedi.12461. Epub 2016 Nov 22.

Low association between fasting and OGTT stimulated glucose levels with HbA1c in overweight children and adolescents.

Author information

1
Public Health Department of Stuttgart, Department of Pediatrics, Dental Health Care, Health Promotion and Social Services, Stuttgart, Germany.
2
Pediatric Endocrinology and Diabetes, University Children's Hospital, University of Tübingen, Tübingen, Germany.
3
Department of Pediatric Endocrinology and Diabetes, Charité Children's Hospital, Universitätsmedizin Berlin, Berlin, Germany.
4
Hospital for Children and Adolescents, Department of Women and Child Health, University Hospitals, University of Leipzig, Leipzig, Germany.
5
Endokrinologikum Berlin am Gendarmenmarkt, Berlin, Germany.
6
Endokrinologikum Hamburg, Hamburg, Germany.
7
Department of Clinical Epidemiology and Applied Biometry, University of Tübingen, Tuebingen, Germany.
8
Division of Pediatric Endocrinology and Diabetes, Interdisciplinary Obesity Unit, Department of Pediatrics and Adolescent Medicine, Ulm University, Ulm, Germany.
9
Department of Pediatric Endocrinology, Diabetes and Nutrition Medicine, Vestische Children's Hospital, University Witten/Herdecke, Datteln, Germany.

Abstract

BACKGROUND:

Diabetes and prediabetes are defined based on different methods such as fasting glucose, glucose at 2-hour in oral glucose tolerance test (OGTT), and glycated hemoglobin A1c (HbA1c). These parameters probably describe different deteriorations in glucose metabolism limiting the exchange between each other in definitions of diabetes.

OBJECTIVE:

To investigate the relationship between OGTT and HbA1c in overweight and obese children and adolescents living in Germany.

METHODS:

Study population: Overweight and obese children and adolescents (n = 4848; 2668 female) aged 7 to 17 years without known diabetes. The study population was stratified into the following subgroups: normal glucose tolerance, prediabetes, diabetes according to OGTT and/or HbA1c categories, confirmed diagnosis of diabetes.

RESULTS:

In the entire study group fasting plasma glucose (FPG) correlated weakly to 2-hour glucose (r = 0.26), FPG correlated weakly to HbA1c (r = 0.18), and 2-hour glucose correlated weakly to HbA1c (r = 0.17, all P < .001). Patients with confirmed diabetes showed a very high correlation between FPG and 2-hour glucose (r = 0.73, n = 50). Moderate correlations could be found for patients with impaired fasting glucose (2-hour glucose vs HbA1c: r = 0.30, n = 436), for patients with diabetes according to OGTT and/or HbA1c (FPG vs 2-hour glucose: r = 0.43; 2-hour glucose vs HbA1c: r = -0.30, n = 115) and for patients with confirmed diabetes (2-hour glucose vs HbA1c: r = -0.47, all P < .001).

CONCLUSIONS:

Because FPG, 2-hour glucose, and HbA1c correlated only weakly we propose that these parameters, particularly in the normal range, might reflect distinct aspects of carbohydrate metabolism.

KEYWORDS:

HbA1c ; OGTT ; children; diabetes; overweight

PMID:
27873429
DOI:
10.1111/pedi.12461
[Indexed for MEDLINE]

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