Current ADA screening techniques have low sensitivity for detecting impaired glucose tolerance
FRIDAY, Jan. 27 (HealthDay News) -- The addition of fasting triglyceride levels to current American Diabetes Association (ADA) screening models improves the diagnostic accuracy of dysglycemia in overweight or obese children, according to a study published online Jan. 23 in Diabetes Care.
Katherine M. Morrison, M.D., from McMaster University in Hamilton, Canada, and colleagues conducted a cross-sectional study of 259 youth aged 5 to 17 to examine the performance of current screening recommendations for detecting dysglycemia. An oral glucose tolerance test and demographic, clinical, and laboratory variables were measured, and glycemic status was based on thresholds from the ADA.
The researchers identified dysglycemia in 20.8 percent of the cohort (58 participants), of whom 68 percent had a normal fasting glucose and were identified using the two-hour glucose test. There was a low sensitivity (41.7 percent) and moderate specificity (69.5 percent) in the performance of ADA screening criteria to identify isolated impaired glucose tolerance. Addition of hemoglobin A1c levels or fasting plasma glucose did not improve the receiver operating characteristic (ROC) area under the curve (AUC). The addition of triglyceride level improved the ROC AUC. Compared with the ADA criteria, a fasting triglyceride level greater than 1.17 mmol/L was found to improve the AUC (0.68 versus 0.57; P = 0.04).
"Current screening criteria have low sensitivity to detect isolated impaired glucose tolerance. Although adding nonfasting laboratory values to history and physical measures does not improve diagnostic accuracy, adding fasting lipid profile improves predictive value," the authors write.
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