Eschwège E, Charles M A, Simon D, Thibult N, Balkau B
Faculty of Medicine, University of Paris XI, Villejuif, France.
Diabetes Care. 2001 Nov;24(11):1941-4. doi: 10.2337/diacare.24.11.1941.
To describe the change in diabetic status over 30 months.
Cohort study of 5,400 Caucasian men from the Paris Prospective Study, aged 44-55 years, who were not known as having diabetes at baseline. Oral glucose tolerance tests were performed at baseline and after 30 months.
At baseline, diabetes was diagnosed in 2.9% of the men by fasting plasma glucose (FPG) > or =7.0 mmol/l and in 0.9% by isolated postchallenge hyperglycemia (IPH) (FPG <7.0 mmol/l and 2-h plasma glucose concentration > or =11.1 mmol/l), i.e., one in four of all men with newly diagnosed diabetes. Thirty months later, 42% of the men with diabetes diagnosed by FPG reverted to nondiabetic status, compared with 72% of those with diabetes diagnosed by IPH (P < 0.0001). For the men with diabetes diagnosed by FPG at baseline, diabetes had been diagnosed by a physician at 30 months in 11.5%, in contrast to only 3.9% of those with diabetes diagnosed by IPH (P < 0.05). For the 51 men with diabetes diagnosed by IPH at baseline, those who reverted to nondiabetic status had a lower frequency of family history of diabetes (P < 0.1), a higher mean corpuscular volume (P < 0.08), and a significantly higher total cholesterol concentration (P < 0.006) at baseline; in contrast, for the 156 men with diabetes diagnosed by FPG at baseline, the men who reverted to nondiabetic status and those who remained diabetic had similar characteristics.
In this epidemiological study, diabetes diagnosed by one FPG concentration was more stable than diabetes diagnosed by one IPH; in clinical practice, the diagnosis of diabetes requires confirmation of the hyperglycemia.
描述30个月内糖尿病状态的变化。
对来自巴黎前瞻性研究的5400名44 - 55岁的白人男性进行队列研究，这些男性在基线时未被诊断为糖尿病。在基线和30个月后进行口服葡萄糖耐量试验。
在基线时，通过空腹血糖（FPG）≥7.0 mmol/l诊断出2.9%的男性患有糖尿病，通过单纯餐后高血糖（IPH）（FPG < 7.0 mmol/l且2小时血浆葡萄糖浓度≥11.1 mmol/l）诊断出0.9%的男性患有糖尿病，即所有新诊断糖尿病男性中的四分之一。30个月后，通过FPG诊断为糖尿病的男性中有42%恢复到非糖尿病状态，而通过IPH诊断为糖尿病的男性中有72%恢复到非糖尿病状态（P < 0.0001）。对于基线时通过FPG诊断为糖尿病的男性，30个月时由医生诊断为糖尿病的比例为11.5%，而通过IPH诊断为糖尿病的男性中这一比例仅为3.9%（P < 0.05）。对于基线时通过IPH诊断为糖尿病的51名男性，恢复到非糖尿病状态的患者在基线时糖尿病家族史的频率较低（P < 0.1），平均红细胞体积较高（P < 0.08），总胆固醇浓度显著较高（P < 0.006）；相比之下，对于基线时通过FPG诊断为糖尿病的156名男性，恢复到非糖尿病状态的男性和仍患有糖尿病的男性具有相似的特征。
在这项流行病学研究中，通过一次FPG浓度诊断的糖尿病比通过一次IPH诊断的糖尿病更稳定；在临床实践中，糖尿病的诊断需要确认高血糖情况。
