Egstrup Michael, Henriksen Finn Lund, Høfsten Dan Eik, Jensen Brian Kloster, Hangaard Jørgen, Egstrup Kenneth
Sygehus Fyn Svendborg, Medicinsk Forskningsafdeling.
Ugeskr Laeger. 2008 Mar 10;170(11):942-6.
The prevalence of previously undiscovered glucometabolic abnormalities such as diabetes and impaired glucose tolerance (IGT) has been shown to be high among selected groups with myocardial infarction. The aim of this study was to establish the prevalence of known diabetes and undiagnosed glucometabolic abnormalities in an unselected population with myocardial infarction (MI) at admission and after 3 months by use of oral glucose tolerance testing (OGTT).
During an 18-month period patients consecutively admitted with acute MI in a Danish coronary care unit were included. Out of the 218 patients included, 44 had known diabetes. Using the results of OGTT and fasting venous plasma glucose measures, the remaining 174 patients were classified in glucometabolic categories. 80 out of 111 invited patients were classified by OGTT after 3 months.
71% of the cohort had abnormal glucose metabolism, 29% IGT, 22% newly detected diabetes and 20% established diabetes. There were no significant differences in body mass index, blood pressure, cholesterol, HDL, LDL or triglycerides in the groups without known diabetes. Patients with abnormal glucose metabolism were older than their normal glucose tolerance counterparts. There was a trend towards normalization of glucometabolism after 3 months.
The prevalence of abnormal glucose metabolism in MI-populations is high. Among individuals with presumably normal glucose tolerance 37% were classified as IGT and 27% as diabetics. Association between common risk factors for both abnormal glucose regulation and MI could not explain these findings. OGTT is probably required for correct diagnosis of abnormal glucose regulation in patients with MI.
在选定的心肌梗死患者群体中，先前未被发现的糖代谢异常（如糖尿病和糖耐量受损[IGT]）的患病率已被证明很高。本研究的目的是通过口服葡萄糖耐量试验（OGTT）确定未经选择的心肌梗死（MI）患者入院时和3个月后的已知糖尿病患病率以及未诊断的糖代谢异常情况。
在18个月期间，纳入丹麦冠心病监护病房连续收治的急性心肌梗死患者。在纳入的218例患者中，44例患有已知糖尿病。利用OGTT结果和空腹静脉血浆葡萄糖测量值，将其余174例患者分类到糖代谢类别中。111例受邀患者中有80例在3个月后通过OGTT进行了分类。
该队列中71%的患者存在糖代谢异常，29%为IGT，22%为新检测出的糖尿病患者，20%为已确诊的糖尿病患者。在无已知糖尿病的组中，体重指数、血压、胆固醇、高密度脂蛋白、低密度脂蛋白或甘油三酯无显著差异。糖代谢异常的患者比糖耐量正常的患者年龄更大。3个月后糖代谢有趋于正常化的趋势。
心肌梗死人群中糖代谢异常的患病率很高。在糖耐量可能正常的个体中，37%被分类为IGT，27%被分类为糖尿病患者。糖代谢异常和心肌梗死的常见危险因素之间的关联无法解释这些发现。对于心肌梗死患者，可能需要进行OGTT以正确诊断糖代谢异常。
