Steno Diabetes Center, Niels Steensens Vej 2, DK-2820, Gentofte, Denmark.
Diabetologia. 2010 May;53(5):858-65. doi: 10.1007/s00125-010-1673-4. Epub 2010 Feb 25.
AIMS/HYPOTHESIS: We aimed to examine whether sex differences in fasting plasma glucose (FPG), 2 h post-OGTT plasma glucose (2hPG) and HbA(1c) could be explained by differences in body size and/or body composition between men and women in a general non-diabetic Danish population. Moreover, we aimed to study to what degree the newly suggested high-risk HbA(1c) criteria overlapped with the current OGTT-based criteria of glucose intolerance.
We used cross-sectional data from 6,006 non-diabetic men and women. HbA(1c) and FPG levels were measured and a 75 g OGTT was performed in all individuals. Height, weight and waist and hip circumferences were measured and BMI was calculated. Data were analysed in age-adjusted linear regression models.
Men had higher FPG and HbA(1c) levels than women, and women had higher 2hPG levels than men. Sex differences in 2hPG levels were explained by differences in height and FPG levels, but sex differences in FPG or HbA(1c) levels were not explained by anthropometric measures. Among individuals with HbA(1c) in the high-risk range (6.0-6.5%), 73% had normal glucose tolerance.
CONCLUSIONS/INTERPRETATION: Sex differences in 2hPG levels after an OGTT may to some extent be a consequence of giving the same amount of glucose to individuals with different body size. In contrast, sex differences in FPG and HbA(1c) levels are likely to have a true physiological basis. In clinical practice, the HbA(1c) assay may be more convenient than the OGTT, but it is important to note that different populations are identified by the two methods.
目的/假设：我们旨在研究在一般非糖尿病丹麦人群中，男女之间空腹血糖（FPG）、口服葡萄糖耐量试验后 2 小时血糖（2hPG）和糖化血红蛋白（HbA(1c)）的性别差异是否可以用男女之间的体型和/或身体成分差异来解释。此外，我们旨在研究新提出的高风险 HbA(1c)标准与目前基于 OGTT 的葡萄糖耐量受损标准有多大程度的重叠。
我们使用了来自 6006 名非糖尿病男女的横断面数据。所有个体均测量了 HbA(1c)和 FPG 水平，并进行了 75g OGTT。测量了身高、体重、腰围和臀围，并计算了 BMI。数据分析采用年龄调整的线性回归模型。
男性的 FPG 和 HbA(1c)水平高于女性，而女性的 2hPG 水平高于男性。OGTT 后 2hPG 水平的性别差异可由身高和 FPG 水平的差异来解释，但 FPG 或 HbA(1c)水平的性别差异不能用人体测量指标来解释。在 HbA(1c)处于高风险范围（6.0-6.5%）的个体中，73%的个体糖耐量正常。
结论/解释：OGTT 后 2hPG 水平的性别差异可能在一定程度上是由于给予不同体型的个体相同量的葡萄糖所致。相比之下，FPG 和 HbA(1c)水平的性别差异可能具有真正的生理基础。在临床实践中，HbA(1c)测定可能比 OGTT 更方便，但需要注意的是，两种方法识别的人群不同。
