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Diabet. Med. 29, e102-e105 (2012) Abstract Aims Childhood obesity is associated with an increased likelihood for having impaired glucose tolerance, dyslipidaemia and diabetes. The aim of the study was to evaluate HbA1c as a screening test for impaired glucose tolerance in obese children and adolescents and identify the optimal HbA1c threshold. Methods We studied 126 obese and overweight children (BMI > 85th percentile for age and gender) 4-17 years of age referred to the endocrine clinic at Ajou University Hospital in Korea. All subjects underwent HbA1c and oral glucose tolerance test. Results Thirty-four patients (27%) out of 126 had impaired glucose tolerance. Silent diabetes was diagnosed in 10 adolescents (7.9%). Based on the receiver operating characteristic curve, the optimal cut point of HbA1c related to impaired glucose tolerance diagnosed by oral glucose tolerance test was 40 mmol/mol (5.8%), which was associated with a 64.7% sensitivity and 61.6% specificity, with an area under the receiver operating characteristic curve of 0.651 (95% CI 0.529-0.772). Conclusions Obesity is associated with an increased risk of impaired glucose tolerance. An HbA1c value of 40 mmol/mol (5.8%) should be used as a screening tool to identify children and adolescents with impaired glucose tolerance. [ABSTRACT FROM AUTHOR]