Alssema Marjan, Schindhelm Roger K, Dekker Jacqueline M, Diamant Michaela, Nijpels Giel, Teerlink Tom, Scheffer Peter G, Kostense Piet J, Heine Robert J
EMGO Institute, VU University Medical Center, 1007 MB Amsterdam, The Netherlands.
Metabolism. 2008 Sep;57(9):1262-9. doi: 10.1016/j.metabol.2008.04.022.
Both postprandial hyperglycemia and hypertriglyceridemia have been identified as risk markers for cardiovascular disease, but parameters associated with these postprandial responses are largely unknown. The objective was to assess whether usually measured clinical and biochemical parameters can predict postprandial glucose and triglyceride responses and whether these responses are associated with each other. Postmenopausal women, 76 with normal glucose metabolism (NGM) and 41 with type 2 diabetes mellitus (T2DM), received 2 consecutive fat-rich meals and carbohydrate-rich meals on separate occasions. Blood samples were taken before and at t = 1, 2, 4, 6, and 8 hours after breakfast; lunch was given at t = 4 hours. Regression analysis was performed with incremental area under the postprandial triglyceride curve (triglyceride-iAUC) and glucose curve (glucose-iAUC) after fat-rich and carbohydrate-rich meals, respectively. In women with NGM, fasting triglycerides, hemoglobin A(1c), total cholesterol, and, inversely, high-density lipoprotein cholesterol were independently associated with triglyceride-iAUC; and age and fasting triglycerides were independently associated with glucose-iAUC. In women with T2DM, fasting triglycerides were independently associated with triglyceride-iAUC, whereas hemoglobin A(1c) and fasting glucose were stronger than fasting triglycerides associated with glucose-iAUC. Glucose-iAUC and triglyceride-iAUC were associated with each other in women with T2DM, but not in those with NGM. The association between glucose-iAUC and triglyceride-iAUC in women with T2DM and the association of fasting triglycerides with both glucose-iAUC and triglyceride-iAUC in NGM and T2DM suggest a common underlying mechanism for postprandial increments in glucose and triglycerides, especially in T2DM. Commonly measured clinical and biochemical parameters can only partly explain postprandial glucose and triglyceride excursions.
餐后高血糖和高甘油三酯血症均已被确定为心血管疾病的风险标志物，但与这些餐后反应相关的参数在很大程度上尚不清楚。目的是评估通常测量的临床和生化参数是否能够预测餐后血糖和甘油三酯反应，以及这些反应是否相互关联。76名葡萄糖代谢正常（NGM）的绝经后女性和41名2型糖尿病（T2DM）女性在不同时间分别连续接受了富含脂肪的餐食和富含碳水化合物的餐食。在早餐前以及早餐后1、2、4、6和8小时采集血样；在4小时时给予午餐。分别对富含脂肪餐食和富含碳水化合物餐食后餐后甘油三酯曲线下增量面积（甘油三酯-iAUC）和葡萄糖曲线下增量面积（葡萄糖-iAUC）进行回归分析。在NGM女性中，空腹甘油三酯、糖化血红蛋白A1c、总胆固醇以及高密度脂蛋白胆固醇与甘油三酯-iAUC独立相关；年龄和空腹甘油三酯与葡萄糖-iAUC独立相关。在T2DM女性中，空腹甘油三酯与甘油三酯-iAUC独立相关，而糖化血红蛋白A1c和空腹血糖比空腹甘油三酯与葡萄糖-iAUC的关联更强。T2DM女性的葡萄糖-iAUC和甘油三酯-iAUC相互关联，但NGM女性则不然。T2DM女性中葡萄糖-iAUC与甘油三酯-iAUC之间的关联以及NGM和T2DM中空腹甘油三酯与葡萄糖-iAUC和甘油三酯-iAUC的关联提示了餐后葡萄糖和甘油三酯升高存在共同的潜在机制，尤其是在T2DM中。通常测量的临床和生化参数只能部分解释餐后血糖和甘油三酯的波动。
