Artículo de revista
Glicemia de ayuno versus prueba de tolerancia oral a la glucosa en la detección de intolerancia a la glucosa en niños y adolescentes obesos
Fecha
2006Autor
Gallardo T., Vivian
Avila, Alejandra
Unuane M., Nancy
Codner Dujovne, Ethel
Institución
Resumen
Background: Recently, the cut-off point for normal fasting glucose
(FG) level, was decreased to 100 mg/dl. Aim: To determine the frequency of abnormal carbohydrate
abnormalities in children with obesity and evaluate if the fasting glucose level is a useful tool for the
screening of glucose intolerance (GI). Patients and methods: Children and adolescents, referred
for evaluation of obesity were evaluated with an oral glucose tolerance test (OGTT) and FG. The
sensitivity of FG for detection of GI, using the 100 and 110 mg/dl cut-off point, was evaluated.
Results: We studied 186 patients (125 females) aged 12.1 (range: 5.4-19.3) years with a body mass
index (BMI) of 29.9 (18.3-44.6) kg/mt2 and a BMI Z score of 2.1 (1.7-3.2). Seven patients (3.8%)
had abnormalities in the carbohydrate metabolism. The sensitivity of FG for the detection of GI using
the 100 and 110 mg/dl cut-off values was 42.9 and 14.3%, respectively. Receiver operating
characteristic (ROC) curves showed that the optimal diagnostic level for FG corresponds to 80 mg/dl
(sensitivity: 85.7% and specificity of 74.9%). Conclusions: An abnormal carbohydrate metabolism
was detected in 3.8% of the obese children and adolescents in this sample. FG of 100 mg/dl does not
detect 57.1% of the patients with glucose intolerance. These data suggest that FG is not a useful
screening tool for glucose intolerance in young patients.