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血糖负荷 30 分钟后血糖升高与血糖正常调节的男性尿白蛋白排泄有关。

Increment of 30-min post-challenge plasma glucose is associated with urine albumin excretion in men with normal glucose regulation.

机构信息

Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.

出版信息

Diabet Med. 2011 Nov;28(11):1323-9. doi: 10.1111/j.1464-5491.2011.03350.x.

Abstract

AIMS

The overwhelming majority of subjects with normal glucose regulation have the highest plasma glucose concentration at 30 minutes during oral glucose tolerance. We aimed to examine the association between increment of 30-min post-challenge glucose and albuminuria in participants with normal glucose regulation.

METHODS

A population-based cross-sectional study was conducted in six communities in Shanghai between 2007 and 2008. A total of 3508 subjects with normal glucose regulation had complete data and were enrolled into the analysis. Among the selected subjects, only 1525 individuals (581 men, 944 women) were examined for their serum insulin levels. We assessed post-challenge blood glucose and insulin at 0, 30 and 120 min, urinary albumin and creatinine. The 30-min post-challenge glucose increment (Δ) was calculated as 30-min post-challenge glucose minus fasting plasma glucose, and albumin/creatinine ratio was used to reflect urinary albumin excretion.

RESULTS

Multivariable logistic regression analysis revealed that the Δ30-min post-challenge glucose was independently associated with increased albumin/creatinine ratio in men with normal glucose regulation (OR = 1.08, P = 0.025), but not in women. Furthermore, multivariable linear regression analysis revealed that early-phase glucose disposition index was the main factor responsible for Δ30-min post-challenge glucose and explained 14-20% of the variance of Δ30-min post-challenge glucose in the two subgroups (P < 0.05). Notably, men had higher Δ30-min post-challenge glucose and lower early-phase glucose disposition index than women (all P < 0.001).

CONCLUSIONS

The 30-min post-challenge plasma glucose increment is associated with urine albumin excretion in men with normal glucose regulation.

摘要

目的

绝大多数血糖正常的受试者在口服葡萄糖耐量试验 30 分钟时血糖最高。本研究旨在探讨血糖正常调节者中,30 分钟餐后血糖增量与白蛋白尿之间的关系。

方法

2007 年至 2008 年期间,在上海的 6 个社区进行了一项基于人群的横断面研究。共有 3508 名血糖正常的受试者完成了完整的数据,并被纳入分析。在所选择的受试者中,只有 1525 人(581 名男性,944 名女性)检查了血清胰岛素水平。我们评估了餐后 0、30 和 120 分钟的血糖和胰岛素、尿白蛋白和肌酐。30 分钟餐后血糖增量(Δ)定义为 30 分钟餐后血糖减去空腹血糖,白蛋白/肌酐比值用于反映尿白蛋白排泄。

结果

多变量逻辑回归分析显示,血糖正常调节的男性中,30 分钟餐后血糖增量与白蛋白/肌酐比值的增加独立相关(OR = 1.08,P = 0.025),但在女性中无此相关性。此外,多变量线性回归分析显示,早期葡萄糖处置指数是导致 30 分钟餐后血糖增量的主要因素,在两个亚组中解释了 14-20%的 30 分钟餐后血糖增量的方差(P < 0.05)。值得注意的是,男性的 30 分钟餐后血糖增量高于女性,早期葡萄糖处置指数低于女性(均 P < 0.001)。

结论

血糖正常调节的男性中,30 分钟餐后血糖增量与尿白蛋白排泄有关。

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