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Article

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

by
Procolo Di Bonito
1,
Maria Rosaria Licenziati
2,
Domenico Corica
3,
Malgorzata Wasniewska
3,
Anna Di Sessa
4,
Emanuele Miraglia del Giudice
4,
Anita Morandi
5,
Claudio Maffeis
5,
Maria Felicia Faienza
6,
Enza Mozzillo
7,
Valeria Calcaterra
8,9,
Francesca Franco
10,
Giulio Maltoni
11 and
Giuliana Valerio
12,*
1
Department of Internal Medicine, “S. Maria delle Grazie” Hospital, 80078 Pozzuoli, Italy
2
Neuro-Endocrine Diseases and Obesity Unit, Department of Neurosciences, Santobono-Pausilipon Children’s Hospital, 80139 Napoli, Italy
3
Department of Human Pathology in Adulthood and Childhood, University of Messina, 98125 Messina, Italy
4
Department of Woman, Child and of General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80138 Napoli, Italy
5
Department of Surgery, Dentistry, Pediatrics and Gynecology, Section of Pediatric Diabetes and Metabolism, University and Azienda Ospedaliera Universitaria Integrata of Verona, 37126 Verona, Italy
6
Department of Precision and Regenerative Medicine and Ionian Area, University of Bari “Aldo Moro”, 70121 Bari, Italy
7
Section of Pediatrics, Department of Translational Medical Science, Regional Center of Pediatric Diabetes, University of Naples “Federico II”, 80131 Napoli, Italy
8
Pediatric Department, “V. Buzzi” Children’s Hospital, 20154 Milano, Italy
9
Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy
10
Pediatric Department, Azienda Sanitaria Universitaria Friuli Centrale, Hospital of Udine, 33100 Udine, Italy
11
Pediatric Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
12
Department of Movement Sciences and Wellbeing, University of Napoli “Parthenope”, 80133 Napoli, Italy
 
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Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2023, 20(2), 928; https://doi.org/10.3390/ijerph20020928
Submission received: 16 November 2022 / Revised: 30 December 2022 / Accepted: 1 January 2023 / Published: 4 January 2023
(This article belongs to the Special Issue Diabetes: Screening, Prevention, Diagnosis and Therapy)
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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 (G60) 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 G60 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 G60, 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 disposition index; glycated hemoglobin A1c; insulin resistance; insulin sensitivity; pediatric obesity; prediabetes

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MDPI and ACS Style

Di Bonito, P.; Licenziati, M.R.; Corica, D.; Wasniewska, M.; Di Sessa, A.; Miraglia del Giudice, E.; Morandi, A.; Maffeis, C.; Faienza, M.F.; Mozzillo, E.; et al. Which Is the Most Appropriate Cut-Off of HbA1c for Prediabetes Screening in Caucasian Youths with Overweight or Obesity? Int. J. Environ. Res. Public Health 2023, 20, 928. https://doi.org/10.3390/ijerph20020928

AMA Style

Di Bonito P, Licenziati MR, Corica D, Wasniewska M, Di Sessa A, Miraglia del Giudice E, Morandi A, Maffeis C, Faienza MF, Mozzillo E, et al. Which Is the Most Appropriate Cut-Off of HbA1c for Prediabetes Screening in Caucasian Youths with Overweight or Obesity? International Journal of Environmental Research and Public Health. 2023; 20(2):928. https://doi.org/10.3390/ijerph20020928

Chicago/Turabian Style

Di Bonito, Procolo, Maria Rosaria Licenziati, Domenico Corica, Malgorzata Wasniewska, Anna Di Sessa, Emanuele Miraglia del Giudice, Anita Morandi, Claudio Maffeis, Maria Felicia Faienza, Enza Mozzillo, and et al. 2023. "Which Is the Most Appropriate Cut-Off of HbA1c for Prediabetes Screening in Caucasian Youths with Overweight or Obesity?" International Journal of Environmental Research and Public Health 20, no. 2: 928. https://doi.org/10.3390/ijerph20020928

APA Style

Di Bonito, P., Licenziati, M. R., Corica, D., Wasniewska, M., Di Sessa, A., Miraglia del Giudice, E., Morandi, A., Maffeis, C., Faienza, M. F., Mozzillo, E., Calcaterra, V., Franco, F., Maltoni, G., & Valerio, G. (2023). Which Is the Most Appropriate Cut-Off of HbA1c for Prediabetes Screening in Caucasian Youths with Overweight or Obesity? International Journal of Environmental Research and Public Health, 20(2), 928. https://doi.org/10.3390/ijerph20020928

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