Value of 1-Hour Plasma Glucose During an Oral Glucose Tolerance Test in a Multiethnic Cohort of Obese Children and Adolescents

Authors

Preneet Cheema Brar, Division of Endocrinology and Diabetes, Department of Pediatrics, New York University Grossman School of Medicine, New York, USA.
Shilpa Mehta, Division of Endocrinology and Diabetes, Department of Pediatrics, New York Medical College, Valhalla, New York, USA.Follow
Ajay Brar, Biology and Public Health, College of Arts and Science, New York University, New York, USA.
Kristyn A. Pierce, Department of Pediatrics, New York University Grossman School of Medicine.
Alesandro Albano, SUNY Downstate College of Medicine, New York, USA.
Michael Bergman, Departments of Medicine and Population Health, Division of Endocrinology, Diabetes and Metabolism, New York University Grossman School of Medicine, New York, USA.

Author Type(s)

Faculty

DOI

10.1177/11795514231177206

Journal Title

Clinical Medicine Insights. Endocrinology and Diabetes

First Page

11795514231177206

Document Type

Article

Publication Date

1-1-2023

Department

Pediatrics

Abstract

UNLABELLED: One hour plasma glucose (1-hr PG) concentration during an oral glucose tolerance test (OGTT) is steadily emerging as an independent predictor of type 2 diabetes (T2D). METHODS: We applied the current cut off thresholds reported in the pediatric literature for the 1-hr PG, 132.5 (7.4 mmol/l) and 155 mg/dL (8.6 mmol/l) during an OGTT, to report abnormal glucose tolerance (AGT) using ROC curve analyses. We determined the empirical optimal cut point for 1-hr PG for our multi ethnic cohort using the Youden Index. RESULTS: About 1-hour and 2-hours plasma glucose showed the highest predictive potential based on Areas under the curve (AUC) values of 0.91 [CI: 0.85, 0.97] and 1 [CI: 1, 1], respectively. Further comparison of the ROC curves of the 1-hour and 2-hour PG measurements as predictors of an abnormal OGTT showed that their associated AUCs differed significantly ((1) = 9.25,  < .05). Using 132.5 mg/dL as the cutoff point for plasma glucose at 1-hour yielded a ROC curve with an AUC of 0.796, a sensitivity of 88%, and a specificity of 71.2%. Alternatively, the cutoff point of 155 mg/dL resulted in a ROC AUC of 0.852, a sensitivity of 80%, and a specificity of 90.4%. CONCLUSION: Our cross-sectional study affirms that the 1-hr PG can identify obese children and adolescents at increased risk for prediabetes and/or T2D with almost the same accuracy as a 2-hr PG. In our multi-ethnic cohort, a 1-hr PG ⩾ 155 mg/dL (8.6 mmol/l) serves as an optimal cut-point, using the estimation of the Youden index with AUC of 0.86 and sensitivity of 80%.We support the petition to consider the 1-hr PG as integral during an OGTT, as this adds value to the interpretation of the OGTT beyond the fasting and 2-hr PG.

Recommended Citation

Brar, P. C., Mehta, S., Brar, A., Pierce, K. A., Albano, A., & Bergman, M. (2023). Value of 1-Hour Plasma Glucose During an Oral Glucose Tolerance Test in a Multiethnic Cohort of Obese Children and Adolescents. Clinical Medicine Insights. Endocrinology and Diabetes, 16, 11795514231177206. https://doi.org/10.1177/11795514231177206