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Cardiometabolic importance of 1-h plasma glucose in obese subjects.
Nutrition & Diabetes ( IF 4.6 ) Pub Date : 2019-05-24 , DOI: 10.1038/s41387-019-0084-y
Lien Haverals 1 , Kristof Van Dessel 1 , An Verrijken 1 , Eveline Dirinck 1 , Frida Peiffer 1 , Ann Verhaegen 1 , Christophe De Block 1 , Luc Van Gaal 1
Affiliation  

BACKGROUND/OBJECTIVES To study the importance and clinical usefulness of the 1-h plasma glucose (1hPG) in a Caucasian obese population with regard to the presence of prediabetes, diabetes, and metabolic syndrome (MetS). SUBJECTS/METHODS We conducted a cross-sectional study of 2439 overweight or obese subjects. All received an oral glucose tolerance test (OGTT) using the American Diabetes Association criteria. ROC-curves were used to compare the sensitivity and (1-specificity) of 1hPG versus FPG and 2hPG to diagnose prediabetes and diabetes. RESULTS Of 2439 patients (72.1% female) (age 43 ± 13 years, BMI 37.9 (34.6-41.6) kg/m2), 1262 (51.7%) had a 1hPG ≥ 155 mg/dL. The prevalence of prediabetes was 33.8% and of diabetes 9.8%. In these 240 diabetic patients, only 1.6% (four patients) did not show a 1hPG ≥ 155 mg/dL. Subjects with 1hPG ≥ 155 mg/dL were more insulin resistant (p < 0.001), had a higher waist (p < 0.001), visceral adipose tissue (VAT) (p < 0.001), systolic blood pressure (p < 0.001), microalbuminuria (p < 0.001), PAI-1 (p < 0.001), and worse lipid profile (p < 0.001) than subjects with 1hPG < 155 mg/dL. MetS was present in 64.1% of subjects with 1hPG ≥ 155 mg/dL versus 42.5% of subjects with 1hPG < 155 mg/dL (p < 0.001). In the group with 1hPG ≥ 155 mg/dL 32.6% had a normal glucose tolerance (NGT), 48.9% had prediabetes, and 18.5% was diagnosed with T2DM compared to 81.7% NGT, 17.7% prediabetes, and 0.6% T2DM in subjects with 1hPG < 155 mg/dL (p < 0.001). Among NGT subjects, 30.0% had a 1hPG ≥ 155 mg/dL and showed higher HOMA-IR (p = 0.008), VAT (p < 0.001), blood pressure (p < 0.001), and worse lipid profile (p = 0.001). Compared to 1hPG < 155 mg/dL, the sensitivity and specificity of 1hPG ≥ 155 mg/dL of prediabetes were 74.8% and 60.0% and for diabetes 97.1% and 53.2%, respectively. CONCLUSIONS This study supports the role of 1hPG value as a valuable tool in the detection of obese subjects at high risk for T2DM and MetS.

中文翻译:

肥胖受试者1 h血浆葡萄糖对心脏代谢的重要性。

背景/目的研究存在糖尿病前期,糖尿病和代谢综合征(MetS)的白种人肥胖人群中1-h血浆葡萄糖(1hPG)的重要性和临床实用性。受试者/方法我们对2439名超重或肥胖的受试者进行了横断面研究。所有患者均接受了根据美国糖尿病协会的标准进行的口服葡萄糖耐量测试(OGTT)。使用ROC曲线比较1hPG与FPG和2hPG的敏感性和(1-特异性),以诊断糖尿病前期和糖尿病。结果在2439名患者中(72.1%为女性)(年龄43±13岁,BMI 37.9(34.6-41.6)kg / m2),1262(51.7%)的1hPG≥155 mg / dL。糖尿病前期的患病率为33.8%,糖尿病为9.8%。在这240名糖尿病患者中,只有1.6%(四名患者)未表现出1hPG≥155 mg / dL。1hPG≥155 mg / dL的受试者对胰岛素的抵抗力更高(p <0.001),腰围更高(p <0.001),内脏脂肪组织(VAT)(p <0.001),收缩压(p <0.001),微量白蛋白尿(p <0.001),PAI-1(p <0.001)和较1hPG <155 mg / dL的受试者更差的脂质分布(p <0.001)。1hPG≥155 mg / dL的受试者中有64.1%存在Met,而1hPG <155 mg / dL的受试者中有42.5%(p <0.001)。在1hPG≥155 mg / dL的组中,有32.6%的葡萄糖耐量(NGT)正常,有48.9%的糖尿病前期,诊断为T2DM的比例为18.5%,而NGT,81.7%的糖尿病前期糖尿病和0.6%的T2DM的受试者1hPG <155 mg / dL(p <0.001)。在NGT受试者中,有30.0%的1hPG≥155 mg / dL,并显示较高的HOMA-IR(p = 0.008),VAT(p <0.001),血压(p <0.001),和更差的脂质分布(p = 0.001)。与1hPG <155 mg / dL相比,1hPG≥155 mg / dL的糖尿病前者的敏感性和特异性分别为74.8%和60.0%,对糖尿病的敏感性和特异性分别为97.1%和53.2%。结论这项研究支持1hPG值作为检测高危T2DM和MetS肥胖受试者中有价值的工具的作用。
更新日期:2019-05-24
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