Zou Chao-Chun, Liang Li, Hong Fang, Zhao Zheng-Yan
Department of Endocrinology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
World J Pediatr. 2008 Feb;4(1):26-30. doi: 10.1007/s12519-008-0005-y.
Continuous glucose monitoring system (CGMS) can measure glucose levels at 5-minute intervals over a few days, and may be used to detect hypoglycemia, guide insulin therapy, and control glucose levels. This study was undertaken to assess the glucose metabolism disorder by CGMS in obese children.
Eighty-four obese children were studied. Interstitial fluid (ISF) glucose levels were measured by CGMS for 24 hours covering the time for oral glucose tolerance test (OGTT). Impaired glucose tolerance (IGT), impaired fasting glucose (IFG), type 2 diabetic mellitus (T2DM) and hypoglycemia were assessed by CGMS.
Five children failed to complete CGMS test. The glucose levels in ISF measured by CGMS were highly correlated with those in capillary samples (r=0.775, P<0.001). However, the correlation between ISF and capillary glucose levels was lower during the first hour than that in the later time period (r=0.722 vs r=0.830), and the ISF glucose levels in 69.62% of children were higher than baseline levels in the initial 1-3 hours. In 79 obese children who finished the CGMS, 2 children had IFG, 2 had IGT, 3 had IFG + IGT, and 2 had T2DM. Nocturnal hypoglycemia was noted during the overnight fasting in 11 children (13.92%).
Our data suggest that glucose metabolism disorder including hyperglycemia and hypoglycemia is very common in obese children. Further studies are required to improve the precision of the CGMS in children.
连续血糖监测系统(CGMS)可以在几天内每隔5分钟测量一次血糖水平,可用于检测低血糖、指导胰岛素治疗以及控制血糖水平。本研究旨在通过CGMS评估肥胖儿童的糖代谢紊乱情况。
对84名肥胖儿童进行研究。通过CGMS测量间质液(ISF)葡萄糖水平24小时,涵盖口服葡萄糖耐量试验(OGTT)时间。通过CGMS评估糖耐量受损(IGT)、空腹血糖受损(IFG)、2型糖尿病(T2DM)和低血糖情况。
5名儿童未能完成CGMS测试。CGMS测量的ISF葡萄糖水平与毛细血管样本中的葡萄糖水平高度相关(r = 0.775,P < 0.001)。然而,在最初1小时内ISF与毛细血管葡萄糖水平之间的相关性低于后期时间段(r = 0.722对r = 0.830),并且在最初1 - 3小时内69.62%儿童的ISF葡萄糖水平高于基线水平。在完成CGMS的79名肥胖儿童中,2名有IFG,2名有IGT,3名有IFG + IGT,2名有T2DM。11名儿童(13.92%)在夜间禁食期间出现夜间低血糖。
我们的数据表明,包括高血糖和低血糖在内的糖代谢紊乱在肥胖儿童中非常常见。需要进一步研究以提高CGMS在儿童中的精度。