[1]刘乐 冯凭.糖负荷后0.5 h高血糖者血糖波动特征分析[J].国际内分泌代谢杂志,2015,(05):302-305.[doi:DOI:10.3760/cma.j.issn.1673-4157.2015.05.004]
　Liu Le*,Feng Ping.Characteristics of plasma glucose excursion in subjects with hyperglycemia at 0.5 hour post glucose load[J].International Journal of Endocrinology and Metabolism,2015,(05):302-305.[doi:DOI:10.3760/cma.j.issn.1673-4157.2015.05.004]
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糖负荷后0.5 h高血糖者血糖波动特征分析()
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《国际内分泌代谢杂志》[ISSN:1673-4157/CN:12-1383/R]

卷:
期数:
2015年05期
页码:
302-305
栏目:
论著
出版日期:
2015-09-20

文章信息/Info

Title:
Characteristics of plasma glucose excursion in subjects with hyperglycemia at 0.5 hour post glucose load
作者:
刘乐 冯凭
300211 天津医科大学第二医院干部保健科(刘乐); 300052 天津医科大学总医院代谢科(冯凭)
Author(s):
Liu Le*;  Feng Ping
The Cadre Sanitarian Division, The 2nd Hospital Affiliated of Tianjin Medical University, Tianjin 300211,China
关键词:
糖尿病;  口服葡萄糖耐量试验;  0.5 h高血糖;  血糖波动;  糖负荷后血糖峰值
Keywords:
Diabetes mellitus;  Oral glucose tolerance test;  0.5-Hour hyperglycemia;  Plasma glucose excursion;  Peak of postload glucose
DOI:
DOI:10.3760/cma.j.issn.1673-4157.2015.05.004
摘要:
目的 分析口服葡萄糖耐量试验(OGTT)负荷后0.5 h高血糖者的血糖波动特征。方法 4 351名受试者行OGTT试验,根据笔者前期试验得出诊断糖代谢异常的0.5 h血糖(0.5 hPG)切点值将整个人群分为糖耐量正常组(n=1 370)、糖尿病前期组(n=1 131)及糖尿病组(n=1 850),进行 0.5 hPG诊断标准及2008年美国糖尿病协会(ADA)诊断标准的一致性检验,比较3组的糖负荷后血糖及胰岛素峰值、胰岛素增量、糖负荷后血糖波动、胰岛素生成指数、Mastuda胰岛素敏感指数、30 min处置指数(DI30),并进行糖负荷后血糖波动与上述指标的线性相关性分析。结果 0.5 hPG诊断标准与2008年ADA诊断标准具有较好的一致性(Kappa=0.563,P<0.001)。应用 0.5 hPG诊断的糖耐量正常组、糖尿病前期组的糖负荷后血糖峰值多数出现在1 h,而糖尿病组的血糖峰值则较多出现在 2 h(χ2 =710.74,P<0.001)。随着 0.5 hPG水平的升高,3组糖负荷后血糖峰值及血糖波动依次增加(F=3 313.21,2 580.53,P均<0.01),而空腹胰岛素、糖负荷后胰岛素峰值、胰岛素增量、生成指数、Matsuda胰岛素敏感指数及DI30逐渐下降(F=8.78～1 697.16,P均<0.01)。糖负荷后血糖波动与生成指数、Matsuda胰岛素敏感指数、DI30呈负相关(r=-0.114,-0.148,-0.639,P均<0.01),与 0.5 hPG呈正相关(r=0.796,P<0.01)。结论 0.5 hPG是诊断糖代谢异常的良好补充,0.5 h高血糖人群中随着血糖水平的升高其糖负荷后血糖峰值出现时间逐渐后延,并且糖负荷后血糖波动逐渐加大。糖负荷后的血糖波动与早时相分泌功能及胰岛素敏感性有关。
Abstract:
Objective To determine the characteristics of glycemic excursion of hyperglycemia at 0.5 h during oral glucose tolerance test(OGTT). Methods A total of 4 351 subjects were recruited to take an OGTT. According to the cutoff values of0.5 h plasma glucose(0.5 hPG)for diagnosing glucose metabolic abnormalities which were concluded in the preliminary experiments by author, all subjects were divided into three groups: normal glucose tolerance group(n=1 370),prediabetes mellitus group(n=1 131)and diabetes mellitus group(n=1 850), and the consistency between 2008 American Diabetes Association(ADA)diagnostic criteria and 0.5 hPG cutoff value was performed. Then the peak plasma glucose and insulin,insulin increment, glucose excursion, insulingenic index, Mastuda insulin insensitivity index, 30 min disposal index among three groups were compared. The correlation between plasma glucose excursion and β-cell function, insulin sensitivity was analyzed with linear correlation.Results 2008-ADA diagnostic criteria and 0.5 hPG diagnostic criteria had good consistency(Kappa=0.563,P<0.001). According to 0.5 hPG cutoff value, peak of plasma glucose occurred at 1-hour in normal glucose tolerance group and prediabetes mellitus group, and 2-hour in diabetes mellitus group(χ2=710.74,P<0.001). Following with the increase of 0.5 hPG,peak plasma glucose and glucose excursion were also increased(F=3 313.21,2 580.53,all P<0.01). However,fasting insulin, insulin peak after glucose loading, insulin increment, insulingenic index, Mastuda insulin insensitivity index and 30 min disposal index decreased(F=8.78-1 697.16, all P<0.01). There was a negative correlation between glucose excursion and insulingenic index, Mastuda insulin insensitivity index,30 min disposal index(r=-0.114,-0.148,-0.639, all P<0.01), and a positive correlation between 0.5 hPG(r=0.796, P<0.01).Conclusions 0.5 hPG cutoff value is a good supplement for diagnosis of glucose metabolism. The peak of plasma glucose delays and the plasma glucose excursion increases followed with the increase of plasma glucose in subjects with hyperglycemia at 0.5 h post glucose-load. Plasma glucose excursion is influenced by early-phase insulin secretion and insulin sensitivity.

参考文献/References:

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备注/Memo

备注/Memo:
作者单位:300211 天津医科大学第二医院干部保健科(刘乐); 300052 天津医科大学总医院代谢科(冯凭) 通信作者:冯凭,Email:xingxing626@sina.com
更新日期/Last Update: 2015-09-20