Tian Jing-yan, Li Guo, Gu Yan-yun, Zhang Xian-Ling, Li Feng-ying, Zhou Wei-bin, Zhang Hong-li, Wang Xiao, Luo Tian-hong, Luo Min
Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrinology and Metabolism, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China.
Zhonghua Nei Ke Za Zhi. 2007 Jul;46(7):555-8.
To evaluate the metabolic characteristics of insulin secretion and insulin sensitivity in isolated impaired fasting glucose (iIFG) and isolated fasting hyperglycemia (IFH) and to clarify the factors responsible for the development of IFH.
Receiver operating characteristic curve (ROC) analysis was conducted in 1852 subjects. Three groups were classified according to a 75 g oral glucose tolerance test (OGTT): (1) normal glucose tolerance (NGT), n = 557; (2) iIFG, n = 221; (3) IFH, n = 81. The three groups were compared with insulin secretion (insulinogenic index) and insulin sensitivity (insulin sensitivity index).
Using ROC analysis, the optimal cut point of fasting plasma glucose (FPG) related to diabetes diagnosis with OGTT was 6.695 mmol/L and the optimal cut point of FPG related to impaired glucose to lerance (IGT) diagnosis with OGTT was 5.590 mmol/L. From NGT to iIFG and IFH in these subjects, the insulinogenic index and insulin sensitivity index showed gradual decrease.
Subjects with iIFG and IFH exhibit distinctly impaired early-phase insulin secretion and insulin sensitivity, indicating that both reduced insulin secretion and insulin resistance are the determinants of deterioration from NGT to iIFG and IFH.
评估单纯空腹血糖受损(iIFG)和单纯空腹血糖升高(IFH)患者胰岛素分泌及胰岛素敏感性的代谢特征,并阐明导致IFH发生的因素。
对1852名受试者进行受试者工作特征曲线(ROC)分析。根据75克口服葡萄糖耐量试验(OGTT)将受试者分为三组:(1)糖耐量正常(NGT)组,n = 557;(2)iIFG组,n = 221;(3)IFH组,n = 81。比较三组的胰岛素分泌(胰岛素生成指数)和胰岛素敏感性(胰岛素敏感指数)。
通过ROC分析,OGTT诊断糖尿病时空腹血糖(FPG)的最佳切点为6.695 mmol/L,OGTT诊断糖耐量受损(IGT)时FPG的最佳切点为5.590 mmol/L。在这些受试者中,从NGT到iIFG和IFH,胰岛素生成指数和胰岛素敏感指数逐渐降低。
iIFG和IFH患者的早期胰岛素分泌和胰岛素敏感性明显受损,表明胰岛素分泌减少和胰岛素抵抗都是导致从NGT进展为iIFG和IFH的决定因素。