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

Preneet Cheema Brar; Shilpa Mehta; Ajay Brar; Kristyn A Pierce; Alesandro Albano; Michael Bergman

doi:10.1177/11795514231177206

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

Clin Med Insights Endocrinol Diabetes. 2023 Jun 9:16:11795514231177206. doi: 10.1177/11795514231177206. eCollection 2023.

Authors

Preneet Cheema Brar¹, Shilpa Mehta², Ajay Brar³, Kristyn A Pierce⁴, Alesandro Albano⁵, Michael Bergman⁶

Affiliations

¹ Division of Endocrinology and Diabetes, Department of Pediatrics, New York University Grossman School of Medicine, New York, USA.
² Division of Endocrinology and Diabetes, Department of Pediatrics, New York Medical College, Valhalla, New York, USA.
³ Biology and Public Health, College of Arts and Science, New York University, New York, USA.
⁴ Department of Pediatrics, New York University Grossman School of Medicine.
⁵ SUNY Downstate College of Medicine, New York, USA.
⁶ Departments of Medicine and Population Health, Division of Endocrinology, Diabetes and Metabolism, New York University Grossman School of Medicine, New York, USA.

Abstract

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 (X²(1) = 9.25, P < .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.

Keywords: 1-Hour plasma glucose; diabetes; insulin resistance; obese adolescents; oral glucose tolerance test.

Publication types

Review