UTILITY OF HEMOGLOBIN A1C FOR DIAGNOSING IMPAIRED GLUCOSE TOLERANCE AMONG OBESE CHILDREN AND ADOLESCENTS IN ALEMBANG Edy

K. Ginting, Aditiawati, Irfanuddin Department of Child Health, Faculty of Medicine, Sriwijaya University Dr. Mohammad Hoesin Palembang Abstract Background Childhood obesity is associated with an increased likelihood for having impaired glucose tolerance, dyslipidaemia and diabetes. Hemoglobin A1c (A1C) has emerged as a recommended diagnostic tool for identifying diabetes and subjects at risk for the disease. This recommendation is based on data in adults showing the relationship between A1C with future development of diabetes. However, studies in the pediatric population are lacking and there is still no standard value of HbA1c in children. Objective The aim of the study was to evaluate HbA1c as a test for impaired glucose tolerance in obese children and adolescents and identify the optimal HbA1c threshold (optimal cut of point). Methods We studied 65 obese and 4 overweight children (BMI +2 SD for age and gender) 10 -15 years of age in Palembang. All subjects underwent HbA1c and oral glucose tolerance test. Results Nineteen patients (28%) out of 69 had impaired glucose tolerance. Based on the ROC, the optimal cut off point of HbA1c related to impaired glucose tolerance diagnosed by oral glucose tolerance test was 5.25%, which was associated with a 63% sensitivity and 64% specificity. The area under the curve ROC for A1C was 0.687 (95% CI 0.54500.670). Conclusions Obesity is associated with an increased risk of impaired glucose tolerance. An HbA1c value of 5.25% should be used as a screening tool to identify children and adolescents with impaired glucose tolerance. Key words: obesity, impaired glucose tolerance, HbA1c