口服葡萄糖耐量试验：临床实践中早期检测急性心肌梗死患者血糖异常的可靠工具：来自GAMI研究的重复口服葡萄糖耐量试验报告

Oral glucose tolerance test: a reliable tool for early detection of glucose abnormalities in patients with acute myocardial infarction in clinical practice: a report on repeated oral glucose tolerance tests from the GAMI study.

作者信息

Wallander Märit, Malmberg Klas, Norhammar Anna, Rydén Lars, Tenerz Ake

机构信息

Department of Cardiology, FoU N5:00, Karolinska University, Hospital Solna, 171 76 Stockholm, Sweden.

出版信息

Diabetes Care. 2008 Jan;31(1):36-8. doi: 10.2337/dc07-1552. Epub 2007 Oct 1.

DOI:10.2337/dc07-1552

PMID:17909086

Abstract

OBJECTIVE

Previously undetected glucose abnormalities are common in patients with acute myocardial infarction (AMI). We evaluated long-term reliability of early glucometabolic classification of patients with AMI by repeated oral glucose tolerance tests (OGTTs).

RESEARCH DESIGN AND METHODS

A glucometabolic OGTT-based classification was obtained in 122 patients by measuring capillary whole-blood glucose. The classification was performed on three occasions, before hospital discharge and 3 and 12 months thereafter.

RESULTS

At discharge, 34, 31, and 34% were classified as having normal glucose tolerance, impaired glucose tolerance (IGT), or type 2 diabetes, respectively, and 93% of all patients with type 2 diabetes were still classified with type 2 diabetes (n = 27) or IGT (n = 12) after 12 months. The agreements between the OGTTs at discharge and 3 and 12 months were kappa = 0.35, P < 0.001, and kappa = 0.43, P < 0.001, respectively.

CONCLUSIONS

The outcome of an OGTT performed in AMI patients at hospital discharge reliably informs on long-term glucometabolic state.

摘要

目的

急性心肌梗死（AMI）患者中先前未被检测到的血糖异常很常见。我们通过重复口服葡萄糖耐量试验（OGTT）评估了AMI患者早期糖代谢分类的长期可靠性。

研究设计与方法

通过测量毛细血管全血葡萄糖，对122例患者进行了基于糖代谢OGTT的分类。在出院前、出院后3个月和12个月进行了三次分类。

结果

出院时，分别有34%、31%和34%的患者被分类为糖耐量正常、糖耐量受损（IGT）或2型糖尿病，12个月后，所有2型糖尿病患者中有93%仍被分类为2型糖尿病（n = 27）或IGT（n = 12）。出院时与3个月和12个月时的OGTT之间的一致性分别为kappa = 0.35，P < 0.001和kappa = 0.43，P < 0.001。