Glucose levels are not the same for everyone: a real-world big data study evaluating fasting serum glucose levels by sex and age among children
-
Carmit Avnon Ziv
,
Tamar Banon
Abstract
Objectives
Understanding the normal range of laboratory values as pertained to different age groups and males or females is paramount in health care delivery. We aimed to assess the distribution of morning fasting serum glucose levels by age and sex in the general population of children using a large-scale population-based cohort.
Methods
A retrospective study with real-world de-identified data from a large, state mandated health fund in Israel among children aged 2–18 years old between 2006 and 2019. Age, sex, and BMI differences in mean glucose levels were evaluated.
Results
Study included 130,170 venous blood samples from 117,411 children, 53.3 % were female. After adjusting for age boys had higher fasting serum glucose levels than girls, with a mean of 89.21 ± 8.66 mg/dL vs. 87.59 ± 8.35 (p<0.001) [4.95 ± 0.48 mmol/L vs. 4.86 ± 0.46]. Compared to the 15 to 18 year-olds (88.49 ± 7.63 mg/dL) [4.92 ± 0.42 mmol/L], 2 to 5 year-olds had lower glucose levels (84.19 ± 10.65, [4.68 ± 0.59] (p<0.001)), 11 to 14 year-olds had higher glucose (90.40 ± 7.42 [5.02 ± 0.41], (p<0.001)) and 6 to 10 year-olds showed no difference (88.45 ± 8.25) [4.91 ± 0.46]. 33.0 % (n=42,991) had a BMI percentile record the same year as their glucose test result. There was a weak yet significant positive association between blood glucose levels and BMI.
Conclusions
Our large cohort indicates that boys have slightly higher fasting serum glucose levels than girls, as do adolescents compared to younger children. This finding is important for the delivery of adequate health care, screening for illness and avoiding unnecessary investigations and tests.
Funding source: Maccabi Health Care Services, Marom program
-
Research ethics: This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the MHS Ethics Committee (No. MHS-20-0010).
-
Informed consent: Not applicable.
-
Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
-
Competing interests: The authors have no conflict of interest. The sponsor had no role in study design; the collection, analysis, and interpretation of data; the writing of the report; and the decision to submit the manuscript for publication.
-
Research funding: This study was funded by Maccabi Healthcare Services “Marom”, a research program for physicians in Maccabi Healthcare Services, Tel Aviv, Israel.
References
1. Tahmasebi, H, Higgins, V, Fung, AWS, Truong, D, White-Al Habeeb, NMA, Adeli, K. Pediatric reference intervals for biochemical markers: gaps and challenges, recent national initiatives and future perspectives. EJIFCC 2017;28:43–63.Suche in Google Scholar
2. Only my health. Available from: https://www.onlymyhealth.com/normal-blood-glucose-in-children-1338210232.Suche in Google Scholar
3. Health hearty. Available from: https://healthhearty.com/blood-sugar-levels-in-children.Suche in Google Scholar
4. Bass, MH. The sugar-content of the blood in childhood. Am J Dis Child 1915;IX:63–9. https://doi.org/10.1001/archpedi.1915.04100430068006.Suche in Google Scholar
5. Colantonio, DA, Kyriakopoulou, L, Chan, MK, Daly, CH, Brinc, D, Venner, AA, et al.. Closing the gaps in pediatric laboratory reference intervals: a caliper database of 40 biochemical markers in a healthy and multiethnic population of children. Clin Chem 2012;58:854–68. https://doi.org/10.1373/clinchem.2011.177741.Suche in Google Scholar PubMed
6. Bandesh, K, Jha, P, Giri, AK, Marwaha, RK, Scaria, V, Tandon, N, et al.. Normative range of blood biochemical parameters in urban Indian school-going adolescents. PLoS One 2019;14:1–15. https://doi.org/10.1371/journal.pone.0213255.Suche in Google Scholar PubMed PubMed Central
7. Peplies, J, Jiménez-Pavón, D, Savva, SC, Buck, C, Günther, K, Fraterman, A, et al.. Percentiles of fasting serum insulin, glucose, HbA1c and HOMA-IR in pre-pubertal normal weight European children from the IDEFICS cohort. Int J Obes 2014;38:S39–47. https://doi.org/10.1038/ijo.2014.134.Suche in Google Scholar PubMed
8. Nguyen, QM, Srinivasan, SR, Xu, JH, Chen, W, Berenson, GS. Fasting plasma glucose levels within the normoglycemic range in childhood as a predictor of prediabetes and type 2 diabetes in adulthood: the bogalusa heart study. Arch Pediatr Adolesc Med 2010;164:124–8. https://doi.org/10.1001/archpediatrics.2009.268.Suche in Google Scholar PubMed
9. Calcaterra, V, Verduci, E, Schneider, L, Cena, H, De Silvestri, A, Vizzuso, S, et al.. Sex-specific differences in the relationship between insulin resistance and adiposity indexes in children and adolescents with obesity. Children 2021;8:449. https://doi.org/10.3390/children8060449.Suche in Google Scholar PubMed PubMed Central
10. Kelsey, MM, Zeitler, PS. Insulin resistance of puberty. Curr Diab Rep. 2016;16:64. https://doi.org/10.1007/s11892-016-0751-5.Suche in Google Scholar PubMed
11. Hammel, MC, Stein, R, Kratzsch, J, Vogel, M, Eckert, AJ, Triatin, D, et al.. Fasting indices of glucose-insulin-metabolism across life span and prediction of glycemic deterioration in children with obesity from new diagnostic cut-offs. Lancet Reg Heal – Eur 2023;30:100652. https://doi.org/10.1016/j.lanepe.2023.100652.Suche in Google Scholar PubMed PubMed Central
12. Martin-Sanchez, FJ, Aguiar-Pulido, V, Lopez-Campos, GH, Peek, N, Sacchi, L. Secondary use and analysis of big data collected for patient care. Yearb Med Inform 2017;26:28–37. https://doi.org/10.15265/iy-2017-008.Suche in Google Scholar PubMed PubMed Central
13. Brinkgreve, RBJ, Kumarswamy, S. Reference manual reference manual. Technology 2008;1:720–66.Suche in Google Scholar
14. Adeli, K. Closing the gaps in pediatric reference intervals: the CALIPER initiative. Clin Biochem 2011;44:480–2. https://doi.org/10.1016/j.clinbiochem.2011.02.017.Suche in Google Scholar PubMed
15. WHO BMI charts. https://www.who.int/toolkits/child-growth-standard. Available from: https://www.who.int/toolkits/child-growth-standard.Suche in Google Scholar
16. Rudesill, CL, Henderson, RA. Normal blood sugar values in children. Am J Dis Child 1941;61:108–15. https://doi.org/10.1001/archpedi.1941.02000070117010.Suche in Google Scholar
17. Güemes, M, Rahman, SA, Hussain, K. What is a normal blood glucose? Arch Dis Child 2016;101:569–74. https://doi.org/10.1136/archdischild-2015-308336.Suche in Google Scholar PubMed
18. Ellitus, DIM. American diabetes association reports of the experts committee on the diagnosis and classification of diabetes mellitus. Diabetes Care 2001;23:S4–19. Available from: http://www.ncbi.nlm.nih.gov/pubmed/12502614.Suche in Google Scholar
19. Follow-up report on the diagnosis of diabetes mellitus. Diabetes Care 2003;26:3160–7. https://doi.org/10.2337/diacare.26.11.3160.Suche in Google Scholar PubMed
20. Lai, DS, Chen, SC, Chang, YH, Chen, CY, Lin, JB, Lin, YJ, et al.. Pediatric reference intervals for several biochemical analytes in school children in central Taiwan. J Formos Med Assoc 2009;108:957–63. https://doi.org/10.1016/S0929-6646(10)60009-5.Suche in Google Scholar PubMed
21. Tahmasebi, H, Higgins, V, Woroch, A, Asgari, S, Adeli, K. Pediatric reference intervals for clinical chemistry assays on Siemens ADVIA XPT/1800 and Dimension EXL in the CALIPER cohort of healthy children and adolescents. Clin Chim Acta 2019;490:88–97. https://doi.org/10.1016/j.cca.2018.12.011.Suche in Google Scholar PubMed
22. Caprio, S. Insulin: the other anabolic hormone of puberty. Acta Paediatr Int J Paediatr Suppl 1999;88:84–7. https://doi.org/10.1111/j.1651-2227.1999.tb14410.x.Suche in Google Scholar PubMed
23. Cristina, K, Gregorio, R, Laurindo, CP, Machado, UF. Estrogen and glycemic homeostasis: the fundamental role of nuclear estrogen receptors ESR1/ESR2 in glucose transporter GLUT4 regulation. Cells 2021;10:99. https://doi.org/10.3390/cells10010099.Suche in Google Scholar PubMed PubMed Central
24. Nadeau, KJ, Anderson, BJ, Berg, EG, Chiang, JL, Chou, H, Copeland, KC, et al.. Youth-onset type 2 diabetes consensus report: current status, challenges, and priorities. Diabetes Care 2016;39:1635–42. https://doi.org/10.2337/dc16-1066.Suche in Google Scholar PubMed PubMed Central
25. Ludvigsson, J, Huus, K, Eklöv, K, Klintström, R, Lahdenperä, A. Fasting plasma glucose levels in healthy preschool children: effects of weight and lifestyle. Acta Paediatr Int J Paediatr 2007;96:706–9. https://doi.org/10.1111/j.1651-2227.2007.00253.x.Suche in Google Scholar PubMed
26. Lloyd, LJ, Langley-Evans, SC, McMullen, S. Childhood obesity and risk of the adult metabolic syndrome: a systematic review. Int J Obes 2012;36:1–11. https://doi.org/10.1038/ijo.2011.186.Suche in Google Scholar PubMed PubMed Central
27. Abbasi, A, Juszczyk, D, van Jaarsveld, CHM, Gulliford, MC. Body mass index and incident type 1 and type 2 diabetes in children and young adults: a retrospective cohort study. J Endocr Soc 2017;1:524–37. https://doi.org/10.1210/js.2017-00044.Suche in Google Scholar PubMed PubMed Central
28. Rossman, H, Shilo, S, Barbash-Hazan, S, Artzi, NS, Hadar, E, Balicer, RD, et al.. Prediction of childhood obesity from nationwide health records. J Pediatr 2021;233:132–140. https://doi.org/10.1016/j.jpeds.2021.02.010.Suche in Google Scholar PubMed
29. Rehman, A, Setter, SM, Vue, MH. Drug-induced glucose alterations Part 2: drug-induced hyperglycemia. Diabetes Spectr 2011;24:234–8. https://doi.org/10.2337/diaspect.24.4.234.Suche in Google Scholar
30. Vue, MH, Setter, SM. Drug-induced glucose alterations part 1: drug-induced hypoglycemia. Diabetes Spectr 2011;24:171–7. https://doi.org/10.2337/diaspect.24.3.171.Suche in Google Scholar
31. Havron, E, Havron, S. What and when in sex education: guiding principles for building sex education programs for youth in Israel. Available from: https://www.hebpsy.net/articles.asp?id=3570.Suche in Google Scholar
© 2023 Walter de Gruyter GmbH, Berlin/Boston
Artikel in diesem Heft
- Frontmatter
- Review
- Systematic literature review of the epidemiology of glycogen storage disease type 1a
- Original Articles
- Excessive weight gain among preschool children during the COVID-19 lockdown in China: a retrospective observational study
- Longitudinal assessment of bone health index as a measure of bone health in short-statured children before and during treatment with recombinant growth hormone
- First results of the growth disorders related twinning programme Partners4Growth implemented at the tertiary university pediatric endocrinology clinics in Bulgaria
- Predictive factors of catch-up growth in term, small for gestational age infants: a two-year prospective observational study in Algeria
- Glucose levels are not the same for everyone: a real-world big data study evaluating fasting serum glucose levels by sex and age among children
- The status and childcare management of overweight and obesity among preschool children in Hangzhou
- The relationship between metabolic syndrome criteria and pentraxin-3 levels in children
- Case Reports
- Variant in the allosteric domain of CPS1 protein associated with effectiveness of N-carbamoyl glutamate therapy in neonatal onset CPS1 deficiency
- Rickets in proximal renal tubular acidosis: a case series of six distinct etiologies
- Successful treatment of hypercalcemia in a Chinese patient with a novel homozygous mutation in the CYP24A1 gene using zoledronic acid: a case report
- A novel mutation in the AMHR2 gene, resulting in persistent Müllerian duct syndrome presenting with bilateral cryptorchidism and obstructed inguinal hernia
- Syndrome of inappropriate secretion of anti-diuretic hormone due to hypothalamic hamartoma: use of tolvaptan
- Letter to the Editor
- CD163+ and CD14+ macrophages are increased in obese children
Artikel in diesem Heft
- Frontmatter
- Review
- Systematic literature review of the epidemiology of glycogen storage disease type 1a
- Original Articles
- Excessive weight gain among preschool children during the COVID-19 lockdown in China: a retrospective observational study
- Longitudinal assessment of bone health index as a measure of bone health in short-statured children before and during treatment with recombinant growth hormone
- First results of the growth disorders related twinning programme Partners4Growth implemented at the tertiary university pediatric endocrinology clinics in Bulgaria
- Predictive factors of catch-up growth in term, small for gestational age infants: a two-year prospective observational study in Algeria
- Glucose levels are not the same for everyone: a real-world big data study evaluating fasting serum glucose levels by sex and age among children
- The status and childcare management of overweight and obesity among preschool children in Hangzhou
- The relationship between metabolic syndrome criteria and pentraxin-3 levels in children
- Case Reports
- Variant in the allosteric domain of CPS1 protein associated with effectiveness of N-carbamoyl glutamate therapy in neonatal onset CPS1 deficiency
- Rickets in proximal renal tubular acidosis: a case series of six distinct etiologies
- Successful treatment of hypercalcemia in a Chinese patient with a novel homozygous mutation in the CYP24A1 gene using zoledronic acid: a case report
- A novel mutation in the AMHR2 gene, resulting in persistent Müllerian duct syndrome presenting with bilateral cryptorchidism and obstructed inguinal hernia
- Syndrome of inappropriate secretion of anti-diuretic hormone due to hypothalamic hamartoma: use of tolvaptan
- Letter to the Editor
- CD163+ and CD14+ macrophages are increased in obese children
