{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:02:45Z","timestamp":1786122165168,"version":"build-2736575974"},"reference-count":34,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>One\u2010hour postload plasma glucose (1h\u2010PG) 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\u2010 and pubertal stage\u2013specific 1h\u2010PG thresholds for identifying prediabetes and Type 2 diabetes (T2D) in children with overweight or obesity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>In this cross\u2010sectional 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\u2009h\u2010PG, NGT with elevated 1\u2009h\u2010PG, prediabetes and T2D. Insulin resistance and \u03b2\u2010cell function indices were assessed. Participants were stratified by chronological age and pubertal stage. The optimal 1h\u2010PG cut\u2010offs were obtained via receiver operating characteristic (ROC) and age\u2010 and pubertal stage\u2010based thresholds were compared for diagnostic performance. These thresholds were then validated in two independent cohorts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among individuals with NGT, those with elevated 1h\u2010PG exhibited greater insulin resistance, impaired \u03b2\u2010cell function and a higher insulin area under the curve (29\u2009916 vs. 23\u2009524,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). 1\u2009h\u2010PG levels increased with pubertal progression. Pubertal stage\u2013specific thresholds showed superior discrimination compared with age\u2010based stratification and adult cut\u2010offs. Compared with adult thresholds (8.6\u2009mmol\/L for prediabetes and 11.6\u2009mmol\/L for T2D), a prepubertal cut\u2010off of 7.78\u2009mmol\/L improved sensitivity for prediabetes (75.40% vs. 56.68%) and a pubertal cut\u2010off of 10.48\u2009mmol\/L improved sensitivity for T2D (89.47% vs. 73.68%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Elevated 1h\u2010PG proved to be a practical marker for identifying early metabolic dysfunction in children and adolescents with euglycemia. Given that widely used adult\u2010derived cut\u2010offs (8.6 and 11.6\u2009mmol\/L) are suboptimal for pediatric populations, we established pubertal stage\u2013specific thresholds that outperformed both age\u2010specific and adult\u2010derived cut\u2010offs. These stage\u2010specific thresholds may serve as an effective screening tool for diabetes risk in children and adolescents with overweight or obesity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.70969","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T05:06:41Z","timestamp":1782882401000},"page":"8469-8481","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pubertal Stage\u2013Based One\u2010hour Postload Glucose Thresholds Improve Identification of Prediabetes and Type 2 Diabetes in Children With Overweight or Obesity"],"prefix":"10.1111","volume":"28","author":[{"given":"Zhaoyuan","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Endocrinology Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children and Adolescents' Health and Diseases  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yangxi","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children and Adolescents' Health and Diseases  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhewen","family":"Qin","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children and Adolescents' Health and Diseases  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9758-5951","authenticated-orcid":false,"given":"Yaru","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children and Adolescents' Health and Diseases  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaixing","family":"Le","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children and Adolescents' Health and Diseases  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuelian","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children and Adolescents' Health and Diseases  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Sun","sequence":"additional","affiliation":[{"name":"Shandong Provincial Hospital Affiliated to Shandong First Medical University  Jinan Shandong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ke","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children and Adolescents' Health and Diseases  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children and Adolescents' Health and Diseases  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guanping","family":"Dong","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children and Adolescents' Health and Diseases  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6405-1251","authenticated-orcid":false,"given":"Junfen","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children and Adolescents' Health and Diseases  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,30]]},"reference":[{"key":"e_1_2_15_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12519-023-00709-7"},{"key":"e_1_2_15_3_1","first-page":"11","article-title":"Epidemiology and Prediction of Overweight and Obesity Among Children and Adolescents Aged 7\u201018\u2009Years in China From 1985 to 2019","volume":"57","author":"Dong Y. 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