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World J Diabetes. Sep 15, 2010; 1(4): 129-134
Published online Sep 15, 2010. doi: 10.4239/wjd.v1.i4.129
Risk factors for impaired glucose tolerance in obese children and adolescents
Michaela Kleber, Gideon de Sousa, Sophie Papcke, Thomas Reinehr
Michaela Kleber, Sophie Papcke, Thomas Reinehr, Vestische Hospital for Children and Adolescents, University of Witten/Herdecke, Datteln 45711, Germany
Gideon de Sousa, Hospital for Children and Adolescents, Dortmund 45801, Germany
Author contributions: Reinehr T and Kleber M designed the research; Reinehr T, de Sousa G, Kleber M and Papcke S performed the research; Papcke S and Reinehr T analyzed the data; and all authors wrote the paper.
Supported by the Grants from the German ‘Competence Net Obesity’, which is supported by the German Federal Ministry of Education and Research, No. 01 GI0839, the University of Witten/Herdecke and the German Ministry of Education and Research (Bundesministerium für Bildung und Forschung; National Genome Research Network, NGFNplus, No. 01GS0820)
Correspondence to: Thomas Reinehr, Professor, Head, Department of Pediatric Endocrinology, Diabetes, and Nutrition Medicine, Vestische Hospital for Children and Adolescents, University of Witten/Herdecke, Dr. F. Steiner Str. 5, Datteln 45711, Germany. t.reinehr@kinderklinik-datteln.de
Telephone: +49-2363-975229 Fax: +49-2363-975218
Received: April 26, 2010
Revised: August 23, 2010
Accepted: August 30, 2010
Published online: September 15, 2010
Abstract

AIM: To investigate which obese children have an increased risk for impaired glucose tolerance (IGT), a risk factor for later diabetes.

METHODS: We studied 169 European untreated obese children and adolescents with normal glucose tolerance at baseline. Waist circumference, fasting glucose, lipids, blood pressure, pubertal stage, 2 h glucose in oral glucose tolerance test (oGTT), and HbA1c were determined at baseline and 1 year later.

RESULTS: One year after baseline, 19 (11.2%) children demonstrated IGT, 4 (2.4%) children had impaired fasting glucose, no (0%) child suffered from diabetes, and 146 (86%) children still showed normal glucose tolerance. At baseline, the children with IGT and with normal glucose tolerance in a one-year follow-up did not differ significantly in respect of any analyzed parameter, apart from pubertal stage. The children developing IGT entered puberty significantly more frequently (37% vs 3%, P < 0.001). One year after baseline, the children with IGT demonstrated significantly increased waist circumference, blood pressure values, insulin and triglyceride concentrations, and insulin resistance index HOMA. The children remaining in the normal glucose tolerance status 1 year after baseline did not demonstrate any significant changes.

CONCLUSION: During the study period of 1 year, more than 10% of the obese children with normal glucose tolerance converted to IGT. Repeated screening with oGTT seems meaningful in obese children entering puberty or demonstrating increased insulin resistance, waist circumference, blood pressure, or triglyceride concentrations.

Keywords: Impaired glucose tolerance; Risk factors; Lipids; Blood pressure; Pubertal stage; Waist circumference