Gómez-Ambrosi Javier, Pastor Carlos, Salvador Javier, Silva Camilo, Rotellar Fernando, Gil M Jesús, Catalán Victoria, Rodríguez Amaia, Cienfuegos Javier A, Frühbeck Gema
Metabolic Research Laboratory, University of Navarra, Pamplona, Spain.
Obes Surg. 2007 May;17(5):585-91. doi: 10.1007/s11695-007-9101-7.
Impaired fasting glucose (IFG) is a pre-diabetic state defined as a fasting plasma glucose (FPG) between 100 and 125 mg/dl. However, individuals in this group do not exhibit the same atherogenic risk.
The atherogenic profile of subjects with IFG >110 mg/dl (IFG110, n = 96) or <110 mg/dl (IFG100, n=131) were compared and the potential differential impact of the waist circumference analyzed. In addition, the same clinical variables were measured in 18 morbidly obese patients (8 males, 10 females; BMI 45.3 +/- 1.9 kg/m2) before and after weight loss following Roux-en-Y gastric bypass (RYGBP), in order to analyze the influence of the reduction in waist circumference on the improvement of the metabolic risk factors.
Individuals in the IFG110 group showed decreased HDL-cholesterol levels together with an increased total cholesterol to HDL ratio (TC/HDL), accompanied by elevated homocysteine concentrations and white blood cell (WBC) count, and higher waist circumference (P<0.05 for all). Significant correlations between waist circumference and HDL-cholesterol (r=-0.200, P<0.05), TC/HDL (r=0.190, P<0.05), WBC count (r=0.299, P<0.05), and QUICKI (r=-0.375, P<0.0001) were observed. An almost 3-fold increase in the prevalence of T2DM in subjects in the IFG110 group as compared to IFG100 was observed. In the group of patients who underwent RYGBP, the reduction in waist circumference was significantly associated with the improvement in insulin sensitivity as evidenced by the QUICKI index (r=-0.582, P<0.05) and the reduction in TC/HDL (r=0.595, P<0.05).
Waist circumference is related to metabolic risk factors associated with increased levels of IFG. Our data support that individuals with IFG >110 mg/dl and a high waist circumference should undergo an OGTT to exclude the presence of diabetes.
空腹血糖受损（IFG）是一种糖尿病前期状态，定义为空腹血糖（FPG）在100至125mg/dl之间。然而，该组个体的动脉粥样硬化风险并不相同。
比较空腹血糖>110mg/dl（IFG110，n = 96）或<110mg/dl（IFG100，n = 131）的受试者的动脉粥样硬化特征，并分析腰围的潜在差异影响。此外，在18例病态肥胖患者（8例男性，10例女性；BMI 45.3±1.9kg/m²）接受Roux-en-Y胃旁路术（RYGBP）减肥前后测量相同的临床变量，以分析腰围减小对代谢危险因素改善的影响。
IFG110组个体的高密度脂蛋白胆固醇（HDL-胆固醇）水平降低，总胆固醇与HDL比值（TC/HDL）升高，同时伴有同型半胱氨酸浓度和白细胞（WBC）计数升高，腰围增大（所有P<0.05）。观察到腰围与HDL-胆固醇（r = -0.200，P<0.05）、TC/HDL（r = 0.190，P<0.05）、WBC计数（r = 0.299，P<0.05）和定量胰岛素敏感性检查指数（QUICKI）（r = -0.375，P<0.0001）之间存在显著相关性。与IFG100组相比，IFG110组受试者2型糖尿病（T2DM）患病率几乎增加了3倍。在接受RYGBP的患者组中，腰围减小与胰岛素敏感性改善显著相关，QUICKI指数（r = -0.582，P<0.05）和TC/HDL降低（r = 0.595，P<0.05）证明了这一点。
腰围与空腹血糖受损水平升高相关的代谢危险因素有关。我们的数据支持空腹血糖>110mg/dl且腰围较大的个体应进行口服葡萄糖耐量试验（OGTT）以排除糖尿病的存在。
