Screening for Turner Syndrome-Associated Hyperglycemia: Evaluating Hemoglobin A1c and Fasting Blood Glucose
Authors' conclusion
The correlation of HbA1c and 2-h OGTT BG is lower in TS than in other published studies regarding type 2 DM. HbA1c is fairly specific for DM in TS but lacks sensitivity, especially at currently utilized levels. Future research should focus on characterizing individuals with TS whose glycemic status is discordant, as this may provide additional insights into the pathophysiology of glucose metabolism in TS. Longitudinal assessment of glycemia as it relates to micro- and macrovascular complications in individuals with TS will further inform DM screening in this population.
Study context
- Population
- Individuals with Turner syndrome (TS) ≥ age 10 from the TS: Genotype Phenotype study (NICHD Data and Specimen Hub (DASH)) with 2-h oral glucose tolerance test (OGTT) blood glucose (BG), hemoglobin A1c (HbA1c) and fasting blood glucose (FBG)complete data
- Participants
- 348 individuals
- Comparison
- HbA1c vs FBG for predicting TS-associated impaired glucose tolerance (IGT) and diabetes mellitus (DM) defined by 2-h OGTT BG
- Outcome
- Correlation between HbA1c, FBG and 2-h OGTT BG; ROC-AUC and optimal cut points for TS-associated IGT (2-h BG ≥7.77 mmol/L) and DM (2-h BG ≥11.10 mmol/L)
Performance
As reported in the abstract
ROC-AUC for predicting IGT and DM
| Test or model | AUC for IGT | AUC for DM |
|---|---|---|
| HbA1c | 0.57 (0.49-0.65) | 0.81 (0.71-0.90) |
| FBG | 0.63 (0.56-0.70) | 0.85 (0.77-0.93) |
AUC for IGT
HbA1c0.57 (0.49-0.65)
FBG0.63 (0.56-0.70)
AUC for DM
HbA1c0.81 (0.71-0.90)
FBG0.85 (0.77-0.93)
Further findings
- HbA1c at cut point 38 mmol/mol (5.6%) for TS-associated DM defined by 2-h OGTT BG
- 67% (95% CI: 47-83%) · sensitivity · specificity 86% (95% CI: 82-90%)
Original publication
Screening for Turner Syndrome-Associated Hyperglycemia: Evaluating Hemoglobin A1c and Fasting Blood Glucose. Horm Res Paediatr. Published 3 October 2023. doi:10.
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