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在绝经后妇女中存在 30 分钟餐后血糖增量与尿白蛋白排泄之间的关联,但在绝经前妇女中不存在这种关联。

Association between an increment of 30-minute postchallenge plasma glucose and urine albumin excretion exists in postmenopausal women but not in premenopausal women.

机构信息

Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated to Sixth People's Hospital, Shanghai Diabetes Institute, Shanghai Clinical Center of Diabetes, Shanghai, China.

出版信息

Menopause. 2011 Dec;18(12):1303-8. doi: 10.1097/gme.0b013e31821f5eff.

Abstract

OBJECTIVE

Usually, the increment of 30-minute postchallenge plasma glucose (ΔG30-0) represents the highest glucose spike in the population with normal glucose regulation (NGR). The aim of this study was to explore the differences in ΔG30-0 and urinary albumin excretion, a marker for widespread vascular damage, between premenopausal and postmenopausal women, and the relationship between ΔG30-0 and urinary albumin excretion.

METHODS

A population-based cross-sectional study, consisting of 5,289 participants aged 20 to 75 years from six different communities, was conducted in Shanghai between 2007 and 2008. We assessed postchallenge blood glucose and insulin at 0-, 30-, and 120-minute urinary albumin and creatinine. ΔG30-0 was calculated as 30-minute postchallenge glucose minus fasting plasma glucose, and the albumin-to-creatinine ratio (ACR) was used to reflect urinary albumin excretion. Among these, the data of 2,240 women with NGR were analyzed.

RESULTS

(1) Postmenopausal women had higher ΔG30-0 and ACR than did premenopausal women (3.55 ± 1.52 mmol/L vs 3.21 ± 1.49 mmol/L and 6.92 [4.91-10.99] mg/g vs 6.18 [4.17-10.07] mg/g, respectively; all P < 0.001). (2) Multivariable logistic regression showed that ΔG30-0 was independently associated with increased ACR in postmenopausal women with NGR (odds ratio, 1.10; P = 0.048) but not in premenopausal women. (3) The main factor associated with ΔG30-0 was the early-phase glucose disposition index drawn from the multivariable linear regression, which explained approximately 19% and 28% of the variation of ΔG30-0 in premenopausal and postmenopausal women, respectively (both P < 0.001).

CONCLUSIONS

In the NGR population, postmenopausal women have higher ΔG30-0 and ACR compared with premenopausal women. The relationship between ΔG30-0 and increased urine albumin excretion existed in postmenopausal women.

摘要

目的

通常情况下,30 分钟餐后血糖增量(ΔG30-0)代表血糖调节正常(NGR)人群中最高的血糖峰值。本研究旨在探讨绝经前后妇女之间ΔG30-0 和尿白蛋白排泄(广泛血管损伤的标志物)的差异,以及ΔG30-0 和尿白蛋白排泄之间的关系。

方法

这是一项基于人群的横断面研究,于 2007 年至 2008 年在上海的六个不同社区中进行,共纳入了 5289 名年龄在 20 至 75 岁之间的参与者。我们评估了餐后 0 分钟、30 分钟和 120 分钟的血糖和胰岛素,以及尿白蛋白和肌酐。ΔG30-0 定义为 30 分钟餐后血糖减去空腹血浆血糖,白蛋白与肌酐比值(ACR)用于反映尿白蛋白排泄。在这些参与者中,分析了 2240 名 NGR 女性的数据。

结果

(1)与绝经前妇女相比,绝经后妇女的ΔG30-0 和 ACR 更高(3.55 ± 1.52 mmol/L 比 3.21 ± 1.49 mmol/L 和 6.92[4.91-10.99]mg/g 比 6.18[4.17-10.07]mg/g,均 P <0.001)。(2)多变量 logistic 回归显示,在 NGR 的绝经后妇女中,ΔG30-0 与 ACR 的增加独立相关(比值比,1.10;P = 0.048),但在绝经前妇女中并非如此。(3)多变量线性回归显示,与ΔG30-0 相关的主要因素是早期糖处置指数,它分别解释了绝经前和绝经后妇女ΔG30-0 变化的约 19%和 28%(均 P <0.001)。

结论

在 NGR 人群中,与绝经前妇女相比,绝经后妇女的ΔG30-0 和 ACR 更高。在绝经后妇女中,ΔG30-0 与尿白蛋白排泄增加之间存在关系。

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