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Objective: This study aimed to compare the discriminating power of HbA1C with other Pre-diabetes diagnostic tests specifically
in high-risk overweight and obese African American children.
Research Design and Methods: A cross-sectional analysis was performed on a sample of 172 children (70 boys, 102 girls) aged
9-11 years with BMI?s above the 85th percentile. Fasting glucose, insulin and HbA1C were analyzed from the plasma samples.
Results: Of the 172 participants included in this analysis, 21 (12.2%) had HbA1C concentrations above the cut-off of 5.7 used
to identify pre-diabetes. None (0%) of these 21 participants, however, were observed to have a glucose concentration above the
pre-diabetes cut-off of 110 mg/dl, and only 13 of 21 participants had HOMA-IR above the pre-diabetes cut-off of 2.5. When
compared to the previously identified glucose cut-off of 110 mg/dl and HOMA-IR cut-off of 2.5 for pre-diabetes, HbA1C showed
high specificity (88 and 93%, respectively) but very low sensitivity (0 and 21%, respectively). Glucose, insulin and HOMA-IR were
significantly interrelated, but HbA1C was not significantly correlated with these biochemical pre-diabetes assessment variables,
nor with anthropometric (BMIz and WC) risk factors.
Conclusion: Our results suggest that HbA1C had poor discrimination power to identify pre-diabetes in overweight and obese
9-11 year old African American children. Future studies are recommended to compare the feasibility, sensitivity and predictive
power of different screening tests currently recommended to avoid inadequacy when screening for pre-diabetes and diabetes.
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