Department of Clinical and Experimental Medicine, Section of Metabolic Diseases and Diabetes, University of Pisa, 56124 Pisa, Italy.
J Clin Endocrinol Metab. 2013 May;98(5):2100-5. doi: 10.1210/jc.2012-3971. Epub 2013 Mar 28.
In subjects with normal glucose tolerance (NGT) 1-hour postload plasma glucose (1-h oral glucose tolerance test [OGTT]) of >155 mg/dL predicts type 2 diabetes (T2DM) and is associated with subclinical atherosclerosis.
The purpose of this study was to evaluate β-cell function, insulin resistance, and cardiovascular risk profile in subjects with NGT with a 1-h OGTT glucose of >155 mg/dL.
The GENFIEV (Genetics, PHYsiopathology, and Evolution of Type 2 diabetes) study is a multicenter study recruiting individuals at high risk of T2DM. A total of 926 subjects underwent a 75-g OGTT for assessment of plasma glucose and C-peptide for mathematical modeling of β-cell function (derivative and proportional control). Fasting insulin, lipid profile, and clinical parameters were determined as well.
A 1-hour OGTT glucose of >155 mg/dL was found in 39% of subjects with NGT, 76% with impaired fasting glucose (IFG), 90% with impaired glucose tolerance (IGT), and 99% and 98% with IFG + IGT or newly diagnosed T2DM, respectively. Among subjects with NGT (n = 474), those with 1-hour OGTT glucose of >155 mg/dL were more insulin-resistant and had worse β-cell function than those with 1-hour OGTT glucose of ≤155 mg/dL. Moreover, glycosylated hemoglobin, blood pressure, low-density lipoprotein cholesterol, and triglycerides were higher in subjects with NGT with 1-hour OGTT glucose of >155 mg/dL, whereas high-density lipoprotein cholesterol was lower compared with that in subjects with NGT with 1-hour OGTT glucose of ≤155 mg/dL. Compared with subjects with IGT, those with NGT with 1-hour OGTT glucose of >155 mg/dL had comparable cardiovascular risk profile and insulin resistance but slightly better β-cell function.
Among subjects with NGT, those with 1-hour OGTT glucose of >155 mg/dL showed lower insulin sensitivity, impaired β-cell function, and worse cardiovascular risk profile and therefore are at greater risk of developing T2DM and cardiovascular disease.
在糖耐量正常（NGT）受试者中，1 小时餐后血浆葡萄糖（1 小时口服葡萄糖耐量试验 [OGTT]）>155mg/dL 预测 2 型糖尿病（T2DM），并与亚临床动脉粥样硬化相关。
本研究旨在评估 1 小时 OGTT 血糖>155mg/dL 的 NGT 受试者的胰岛β细胞功能、胰岛素抵抗和心血管风险特征。
GENFIEV（2 型糖尿病的遗传学、病理生理学和演变）研究是一项多中心研究，招募了 T2DM 高危个体。共有 926 名受试者接受 75gOGTT 以评估血浆葡萄糖和 C 肽，用于胰岛β细胞功能的数学建模（衍生和比例控制）。还测定了空腹胰岛素、血脂谱和临床参数。
NGT 受试者中 39%、IFG 受试者中 76%、IGT 受试者中 90%、IFG+IGT 受试者中 99%和新诊断的 T2DM 受试者中 98%的 1 小时 OGTT 血糖>155mg/dL。在 NGT 受试者（n=474）中，1 小时 OGTT 血糖>155mg/dL 的受试者比 1 小时 OGTT 血糖≤155mg/dL 的受试者胰岛素抵抗更严重，胰岛β细胞功能更差。此外，1 小时 OGTT 血糖>155mg/dL 的 NGT 受试者的糖化血红蛋白、血压、低密度脂蛋白胆固醇和甘油三酯较高，而高密度脂蛋白胆固醇则较低。与 IGT 受试者相比，1 小时 OGTT 血糖>155mg/dL 的 NGT 受试者具有相似的心血管风险特征和胰岛素抵抗，但胰岛β细胞功能稍好。
在 NGT 受试者中，1 小时 OGTT 血糖>155mg/dL 的受试者表现出较低的胰岛素敏感性、受损的胰岛β细胞功能和更差的心血管风险特征，因此患 T2DM 和心血管疾病的风险更高。
