Screening for cystic fibrosis-related diabetes and prediabetes: Evaluating 1,5-anhydroglucitol, fructosamine, glycated albumin, and hemoglobin A1c.
Pediatr Diabetes
; 20(8): 1080-1086, 2019 12.
Article
in En
| MEDLINE
| ID: mdl-31469470
ABSTRACT
OBJECTIVE:
Dysglycemia is prevalent in cystic fibrosis (CF) but screening with annual oral glucose tolerance tests (OGTT) can be burdensome. We investigated alternate glycemic markers-hemoglobin A1c (HbA1c), 1,5-anhydroglucitol (1,5AG), fructosamine (FA), and glycated albumin (GA)-as screening tests for CF-related diabetes (CFRD) and pre-diabetes (CFPD) in youth with CF as defined by the gold-standard OGTT 2-hour glucose (2hG).METHODS:
Youth 10 to 18 years with CF had a 1,5AG, FA, GA, HbA1c, and 2-hour OGTT collected. Correlations between all glycemic markers and 2hG were evaluated. Area under the receiver operative characteristic (ROC-AUC) curves were generated. Optimal cut points for predicting CFPD (2hG ≥ 140 mg/dL) and CFRD (2hG ≥ 200 mg/dL) were determined.RESULTS:
Fifty-eight youth with CF were included (2hG < 140, n = 16; CFPD, n = 33; CFRD, n = 9; 41% male, mean ± SD age 14.2 ± 3.6 years, BMI z-score 0.0 ± 0.8, % predicted forced expiratory volume in 1 second [FEV1] 89.9 ± 15.1, % predicted forced vital capacity [FVC] 103.2 ± 14.6). ROC-AUC's for all alternate markers were low for CFPD (0.52-0.67) and CFRD (0.56-0.61). At a cut point of 5.5%, HbA1c had 78% sensitivity (95% CI 0.45-0.94) and 41% specificity (95% CI 0.28-0.55) for identifying CFRD, correlating to a ROC-AUC of 0.61 (95% CI 0.42-0.8).CONCLUSIONS:
All alternate markers tested demonstrate poor diagnostic accuracy for identifying CFRD by 2hG.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Prediabetic State
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Glycated Hemoglobin
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Serum Albumin
/
Fructosamine
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Cystic Fibrosis
/
Deoxyglucose
Type of study:
Diagnostic_studies
/
Etiology_studies
/
Prognostic_studies
/
Screening_studies
Limits:
Adolescent
/
Child
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Female
/
Humans
/
Male
Language:
En
Journal:
Pediatr Diabetes
Journal subject:
ENDOCRINOLOGIA
Year:
2019
Type:
Article