Which Is the Most Appropriate Cut-Off of HbA1c for Prediabetes Screening in Caucasian Youths with Overweight or Obesity?

Procolo Di Bonito, Maria Rosaria Licenziati, Domenico Corica, Malgorzata Wasniewska, Anna Di Sessa, Emanuele Miraglia del Giudice, Anita Morandi, Claudio Maffeis, Maria Felicia Faienza, Enza Mozzillo, Valeria Calcaterra, Francesca Franco, Giulio Maltoni and Giuliana Valerio ()
Additional contact information
Procolo Di Bonito: Department of Internal Medicine, “S. Maria delle Grazie” Hospital, 80078 Pozzuoli, Italy
Maria Rosaria Licenziati: Neuro-Endocrine Diseases and Obesity Unit, Department of Neurosciences, Santobono-Pausilipon Children’s Hospital, 80139 Napoli, Italy
Domenico Corica: Department of Human Pathology in Adulthood and Childhood, University of Messina, 98125 Messina, Italy
Malgorzata Wasniewska: Department of Human Pathology in Adulthood and Childhood, University of Messina, 98125 Messina, Italy
Anna Di Sessa: Department of Woman, Child and of General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80138 Napoli, Italy
Emanuele Miraglia del Giudice: Department of Woman, Child and of General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80138 Napoli, Italy
Anita Morandi: Department of Surgery, Dentistry, Pediatrics and Gynecology, Section of Pediatric Diabetes and Metabolism, University and Azienda Ospedaliera Universitaria Integrata of Verona, 37126 Verona, Italy
Claudio Maffeis: Department of Surgery, Dentistry, Pediatrics and Gynecology, Section of Pediatric Diabetes and Metabolism, University and Azienda Ospedaliera Universitaria Integrata of Verona, 37126 Verona, Italy
Maria Felicia Faienza: Department of Precision and Regenerative Medicine and Ionian Area, University of Bari “Aldo Moro”, 70121 Bari, Italy
Enza Mozzillo: Section of Pediatrics, Department of Translational Medical Science, Regional Center of Pediatric Diabetes, University of Naples “Federico II”, 80131 Napoli, Italy
Valeria Calcaterra: Pediatric Department, “V. Buzzi” Children’s Hospital, 20154 Milano, Italy
Francesca Franco: Pediatric Department, Azienda Sanitaria Universitaria Friuli Centrale, Hospital of Udine, 33100 Udine, Italy
Giulio Maltoni: Pediatric Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
Giuliana Valerio: Department of Movement Sciences and Wellbeing, University of Napoli “Parthenope”, 80133 Napoli, Italy

IJERPH, 2023, vol. 20, issue 2, 1-9

Abstract: This cross-sectional study aimed to assess the best cut-off of HbA1c for detection of impaired fasting glucose (IFG), impaired glucose tolerance (IGT), beta-cell impairment and cardiometabolic risk (CMR) profile in overweight or obese (OW/OB) Caucasian youths. Two-hour oral glucose tolerance test was available in 1549 youths, one-hour glucose (G 60 ) in 1430 youths and disposition index (DI) in 972 youths. Insulin resistance (IR) was calculated as Homeostatic Model Assessment for IR and insulin sensitivity (IS) as 1/fasting insulin. High G 60 was defined by a value ≥ 133 mg/dL. The best cut-off of HbA1c for IFG or IGT was 5.5%. The frequency of individuals with HbA1c ≥ 5.5% was 32.5%, compared to 16.3% with HbA1c ≥ 5.7% (as proposed by the American Diabetes Association). HbA1c ≥ 5.5% showed higher sensitivity and lower specificity with respect to HbA1c ≥ 5.7% for all the abnormalities examined (IFG, IGT, high G 60 , IR, low IS, DI and CMR factors). In conclusion, this lower cut-off might represent a more appropriate screening marker of glucose dysmetabolism in youths with OW/OB. Prospective studies are needed to validate this cut-off for predicting prediabetes/diabetes in youths with OW/OB.

Keywords: disposition index; glycated hemoglobin A1c; insulin resistance; insulin sensitivity; pediatric obesity; prediabetes (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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