Kan-etsu Chuo Hospital Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine Gunma University Health and Medical Center Ono Naika Clinic, Gunma, Japan.
Diabet Med. 2010 Dec;27(12):1430-5. doi: 10.1111/j.1464-5491.2010.03144.x.
The study aimed to investigate early-stage atherosclerosis in patients with impaired fasting glucose compared with patients with impaired glucose tolerance.
Body mass index, systolic blood pressure, fasting plasma glucose, lipid variables, ankle-brachial pressure index and brachial-ankle pulse wave velocity were measured in 2842 subjects from Takasaki city located approximately 100 km north of Tokyo in Japan. The subjects were divided into the following five groups based on a 75-g oral glucose tolerance test: (i) normal fasting plasma glucose/normal glucose tolerance group, (ii) impaired fasting glucose group, (iii) impaired glucose tolerance group, (iv) combined glucose intolerance group and (v) diabetic glucose intolerance group.
In comparison with fasting plasma glucose levels (r = 0.269, P < 0.0001), 2-h post-challenge glucose levels were more closely correlated with pulse wave velocity values (r = 0.300, P < 0.0001). The groups with impaired glucose tolerance, combined glucose intolerance and diabetic glucose intolerance had significantly higher pulse wave velocity values compared with the groups with normal glucose tolerance and impaired fasting glucose. Multiple regression analyses showed an independent association of age, systolic blood pressures, total cholesterol, fasting and 2h plasma glucose with pulsewave velocityvalues. Furthermore, pulse wave velocity was not significantly correlated with fasting plasma glucose, but was correlated with increased 2h plasma glucose.
Groups with impaired glucose tolerance and combined glucose intolerance had significantly higher brachio-ankle pulse wave velocity values compared with the group with normal glucose tolerance. Although the group with impaired fasting glucose showed a marginal increase in pulse wave velocity values compared with the group with normal glucose tolerance, the difference was not significant. Thus impaired glucose tolerance, but not impaired fasting glucose, is a risk factor for early-stage atherosclerosis.
本研究旨在比较空腹血糖受损患者与葡萄糖耐量受损患者的早期动脉粥样硬化情况。
在日本高崎市对约 100 公里外东京以北的 2842 名受试者进行了体重指数、收缩压、空腹血糖、血脂变量、踝臂血压指数和臂踝脉搏波速度的测量。根据 75g 口服葡萄糖耐量试验，将受试者分为以下五组：（i）正常空腹血糖/正常糖耐量组，（ii）空腹血糖受损组，（iii）葡萄糖耐量受损组，（iv）联合糖耐量受损组和（v）糖尿病糖耐量受损组。
与空腹血糖水平相比（r = 0.269，P < 0.0001），2 小时餐后血糖水平与脉搏波速度值的相关性更强（r = 0.300，P < 0.0001）。葡萄糖耐量受损、联合糖耐量受损和糖尿病糖耐量受损组的脉搏波速度值明显高于正常糖耐量和空腹血糖受损组。多元回归分析显示，年龄、收缩压、总胆固醇、空腹和 2 小时血浆葡萄糖与脉搏波速度值独立相关。此外，脉搏波速度与空腹血浆葡萄糖无显著相关性，但与餐后 2 小时血浆葡萄糖的升高相关。
与正常糖耐量组相比，葡萄糖耐量受损和联合糖耐量受损组的臂踝脉搏波速度值明显升高。尽管空腹血糖受损组的脉搏波速度值与正常糖耐量组相比略有升高，但差异无统计学意义。因此，葡萄糖耐量受损而不是空腹血糖受损是早期动脉粥样硬化的危险因素。
