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中国部分地区亚人群中原发性高血压住院患者的糖代谢状态

Glucometabolic state of in-hospital patients with primary hypertension in sub-population of partial regions in China.

作者信息

Chen Y-X, Wang X-Q, Wang J-F, Fang C-F, Tang L-J, Nie R-Q, Zhou S-X, Wei Y-L

机构信息

Department of Cardiology, The Second Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.

出版信息

J Hum Hypertens. 2008 May;22(5):346-51. doi: 10.1038/sj.jhh.1002327. Epub 2008 Jan 17.

Abstract

Abnormal glucose metabolism (AGM) is common but underestimated in patients with coronary heart disease (CHD). Here, we reported 898 in-hospital patients with primary hypertension (PH) at the university hospitals in developed regions of China. Oral glucose tolerance test (OGTT) was performed in those without known type-2 diabetes mellitus (2-DM). A total of 158 patients had known 2-DM and 32 were newly diagnosed as 2-DM by fasting blood glucose (FBG). OGTT revealed that 83 had 2-DM and 296 had impaired glucose tolerance (IGT). The proportion of 2-DM and AGM increased from 21.2 to 30.4% and from 57.5 to 68.7% upon OGTT. Prevalence of AGM and 2-DM increased with the increase of age, and incidence of AGM and 2-DM was significant higher in patients with risk factors (including CHD, overweight, hyperlipidaemia, proteinuria) than those without risk factors mentioned above. Glucose was not sufficiently controlled in 55.1% of the patients with 2-DM upon treatment, well controlled in 35.4% and not controlled in 9.5%. So AGM is also prevalent in PH patients especially the elders and those with risk factors, which was underestimated in most cases. Moreover, much lower awareness, treatment and control of 2-DM occurred in some regions of China, thus strengthening health education for patients and heightening consciousness of doctor are very important and eminent. Except for FBG, more attention should be paid to postprandial blood glucose ignored before, and OGTT should be a routine procedure in PH patients, especially in older patients and those with the factors mentioned above.

摘要

异常糖代谢(AGM)在冠心病(CHD)患者中很常见,但却被低估了。在此,我们报告了中国发达地区大学医院的898例住院原发性高血压(PH)患者。对那些无已知2型糖尿病(2-DM)的患者进行了口服葡萄糖耐量试验(OGTT)。共有158例患者已知患有2-DM,32例通过空腹血糖(FBG)新诊断为2-DM。OGTT显示,83例患有2-DM,296例有糖耐量受损(IGT)。经OGTT后,2-DM和AGM的比例从21.2%增至30.4%,从57.5%增至68.7%。AGM和2-DM的患病率随年龄增长而增加,有危险因素(包括冠心病、超重、高脂血症、蛋白尿)的患者中AGM和2-DM的发生率显著高于无上述危险因素的患者。治疗后,55.1%的2-DM患者血糖控制不佳,35.4%控制良好,9.5%未得到控制。所以AGM在PH患者中也很普遍,尤其是老年人和有危险因素的患者,在大多数情况下其被低估了。此外,在中国一些地区,2-DM的知晓率、治疗率和控制率低得多,因此加强对患者的健康教育和提高医生的意识非常重要且迫切。除FBG外,应更多关注以往被忽视的餐后血糖,OGTT应成为PH患者的常规检查项目,尤其是老年患者和有上述因素的患者。

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