HbA1c and the Prediction of Type 2 Diabetes in Children and Adults.

Cancer Genetics and Cytogenetics Pub Date : 2017-01-01 Epub Date: 2016-11-03 DOI:10.2337/dc16-1358
Pavithra Vijayakumar, Robert G Nelson, Robert L Hanson, William C Knowler, Madhumita Sinha
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Abstract

Objective: Long-term data validating glycated hemoglobin (HbA1c) in assessing the risk of type 2 diabetes in children are limited. HbA1c, 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], HbA1c ≥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 HbA1c, 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 HbA1c ≥5.7% as in those with HbA1c ≤5.3%-greater rate ratios than experienced by adults in the same HbA1c categories. Analyses of ROCs revealed no significant differences between HbA1c, FPG, and 2hPG in sensitivity and specificity for identifying children and adolescents who later developed diabetes.

Conclusions: HbA1c 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.

HbA1c 与儿童和成人 2 型糖尿病的预测。
目的:验证糖化血红蛋白(HbA1c)在评估儿童罹患 2 型糖尿病风险方面的长期数据十分有限。在一项针对美国印第安人的纵向研究中测量了 HbA1c、空腹血浆葡萄糖(FPG)和负荷后 2 小时血浆葡萄糖(2hPG)的浓度,以确定它们在预测糖尿病发病中的作用,在这一人群中,所有糖尿病都被认为是 2 型糖尿病:对 2,095 名 10-19 岁无糖尿病的儿童(监测至 39 岁)和 2,005 名 20-39 岁的成年人(监测至 59 岁)进行了糖尿病发病率(FPG ≥126 mg/dL [7.0 mmol/L]、2hPG ≥200 mg/dL [11.1 mmol/L]、HbA1c ≥6.5% [8 mmol/mol] 或临床诊断)测定。比较了 HbA1c、FPG 和 2hPG 预测 10 年内糖尿病的接收器操作特征曲线下面积:结果:在对最初未患糖尿病的儿童和青少年进行长期随访期间,HbA1c ≥5.7%的儿童和青少年与 HbA1c ≤5.3%的儿童和青少年相比,后患糖尿病的发病率分别高出四倍(男孩)和七倍多(女孩)--与相同 HbA1c 类别的成年人相比,这一比率更高。ROC分析表明,HbA1c、FPG和2hPG在识别后来患糖尿病的儿童和青少年的灵敏度和特异性方面没有显著差异:结论:HbA1c 是预测儿童糖尿病风险的有效指标,可用于识别具有其他 2 型糖尿病风险因素的儿童中的糖尿病前期,其预测价值与 FPG 和 2hPG 相同。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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