Pubertal Stage–Based One‐hour Postload Glucose Thresholds Improve Identification of Prediabetes and Type 2 Diabetes in Children With Overweight or Obesity

作者：Zhaoyuan Wu, Y C Li, Zhewen Qin, Ya‐Ru Liu, Kaixing Le, Xuelian Zhou, Yan Sun, Ke Huang, Wei Wu, G P Dong, Junfen Fu · 发表于：Diabetes Obesity and Metabolism · 年份：2026 · DOI：10.1111/dom.70969 · 研究领域：Diabetes, Cardiovascular Risks, and Lipoproteins、Diabetes Management and Research、Obesity, Physical Activity, Diet

AIMS: One-hour postload plasma glucose (1h-PG) is an early marker of dysglycemia in adults, but its utility in children and adolescents is uncertain because insulin sensitivity changes during growth and puberty. We aimed to establish age- and pubertal stage-specific 1h-PG thresholds for identifying prediabetes and Type 2 diabetes (T2D) in children with overweight or obesity. MATERIALS AND METHODS: In this cross-sectional study, 4344 children and adolescents with overweight or obesity underwent an oral glucose tolerance test. Participants were classified into four groups: normal glucose tolerance (NGT) with normal 1 h-PG, NGT with elevated 1 h-PG, prediabetes and T2D. Insulin resistance and β-cell function indices were assessed. Participants were stratified by chronological age and pubertal stage. The optimal 1h-PG cut-offs were obtained via receiver operating characteristic (ROC) and age- and pubertal stage-based thresholds were compared for diagnostic performance. These thresholds were then validated in two independent cohorts. RESULTS: Among individuals with NGT, those with elevated 1h-PG exhibited greater insulin resistance, impaired β-cell function and a higher insulin area under the curve (29 916 vs. 23 524, p < 0.001). 1 h-PG levels increased with pubertal progression. Pubertal stage-specific thresholds showed superior discrimination compared with age-based stratification and adult cut-offs. Compared with adult thresholds (8.6 mmol/L for prediabetes and 11.6 mmol/L for ...