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HbA(1c) and the Prediction of Type 2 Diabetes in Children and Adults

OBJECTIVE: Long-term data validating glycated hemoglobin (HbA(1c)) in assessing the risk of type 2 diabetes in children are limited. HbA(1c), fasting plasma glucose (FPG), and 2-h postload plasma glucose (2hPG) concentrations were measured in a longitudinal study of American Indians to determine the...

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Detalles Bibliográficos
Autores principales: Vijayakumar, Pavithra, Nelson, Robert G., Hanson, Robert L., Knowler, William C., Sinha, Madhumita
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Diabetes Association 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5180461/
https://www.ncbi.nlm.nih.gov/pubmed/27810987
http://dx.doi.org/10.2337/dc16-1358
Descripción
Sumario:OBJECTIVE: Long-term data validating glycated hemoglobin (HbA(1c)) in assessing the risk of type 2 diabetes in children are limited. HbA(1c), fasting plasma glucose (FPG), and 2-h postload plasma glucose (2hPG) concentrations were measured in a longitudinal study of American Indians to determine their utility in predicting incident diabetes, all of which is thought to be type 2 in this population. RESEARCH DESIGN AND METHODS: Incident diabetes (FPG ≥126 mg/dL [7.0 mmol/L], 2hPG ≥200 mg/dL [11.1 mmol/L], HbA(1c) ≥6.5% [8 mmol/mol], or clinical diagnosis) was determined in 2,095 children without diabetes ages 10–19 years monitored through age 39, and in 2,005 adults ages 20–39 monitored through age 59. Areas under the receiver operating characteristic (ROC) curve for HbA(1c), FPG, and 2hPG in predicting diabetes within 10 years were compared. RESULTS: During long-term follow-up of children and adolescents who did not initially have diabetes, the incidence rate of subsequent diabetes was fourfold (in boys) as high and more than sevenfold (in girls) as high in those with HbA(1c) ≥5.7% as in those with HbA(1c) ≤5.3%—greater rate ratios than experienced by adults in the same HbA(1c) categories. Analyses of ROCs revealed no significant differences between HbA(1c), FPG, and 2hPG in sensitivity and specificity for identifying children and adolescents who later developed diabetes. CONCLUSIONS: HbA(1c) is a useful predictor of diabetes risk in children and can be used to identify prediabetes in children with other type 2 diabetes risk factors with the same predictive value as FPG and 2hPG.