Section of Endocrinology, Department of Clinical Pathophysiology, University of Florence, Florence, Italy.
Diabetes Care. 2010 Feb;33(2):411-3. doi: 10.2337/dc09-1342. Epub 2009 Nov 16.
To assess the association of 1-h plasma glucose (1hPG) and inflammation with normal glucose tolerance (NGT) and pre-diabetes.
A cohort of 1,062 subjects was enrolled. After oral glucose load (oral glucose tolerance test), we compared subjects with NGT and pre-diabetes above and below the 1hPG cut point (155 mg/dl). Fibrinogen and leukocytes count (white blood cells [WBCs]) for subclinical inflammation, lipid ratios, insulin sensitivity (Matsuda index) were determined.
Patients with NGT and pre-diabetes (1hPG >155 mg/dl) showed a significant increase of inflammatory markers and lipid ratios (for all, P < 0.05). In age-, sex-, and BMI-adjusted analysis, 1hPG was associated with a significantly higher WBC count and fibrinogen (P < 0.05). Patients with elevated 1hPG showed a highly significant lower insulin sensitivity than subjects <1hPG (P < 0.01).
Elevated 1hPG in subjects with NGT and pre-diabetes is associated with subclinical inflammation, high lipid ratios, and insulin resistance. Therefore, 1hPG >155 mg/dl could be considered a new "marker" for cardiovascular risk.
评估 1 小时血浆葡萄糖(1hPG)和炎症与正常糖耐量(NGT)和糖尿病前期的关系。
纳入了 1062 名受试者。口服葡萄糖负荷(口服葡萄糖耐量试验)后,我们比较了 1hPG 切点(155mg/dl)以上和以下的 NGT 和糖尿病前期患者。为了评估亚临床炎症,测定了纤维蛋白原和白细胞计数(白细胞[WBCs]),还测定了血脂比值和胰岛素敏感性(Matsuda 指数)。
NGT 和糖尿病前期患者(1hPG>155mg/dl)的炎症标志物和血脂比值显著升高(均 P<0.05)。在年龄、性别和 BMI 校正分析中,1hPG 与白细胞计数和纤维蛋白原显著升高相关(均 P<0.05)。与 1hPG<1hPG 的患者相比,1hPG 升高的患者胰岛素敏感性显著降低(P<0.01)。
NGT 和糖尿病前期患者的 1hPG 升高与亚临床炎症、高血脂比值和胰岛素抵抗有关。因此,1hPG>155mg/dl 可被视为心血管风险的新“标志物”。