尿肌醇作为葡萄糖不耐受标志物的效用。

The utility of urinary myo-inositol as a marker of glucose intolerance.

机构信息

Department of Environmental Medicine and Infectious Disease, Kyushu University, Fukuoka, Japan.

Department of Environmental Medicine and Infectious Disease, Kyushu University, Fukuoka, Japan; Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan.

出版信息

Diabetes Res Clin Pract. 2014 Jan;103(1):88-96. doi: 10.1016/j.diabres.2013.11.018. Epub 2013 Dec 4.

DOI:10.1016/j.diabres.2013.11.018

PMID:24377833

Abstract

OBJECTIVE

The most common screening tests for glucose intolerance are fasting plasma glucose (FPG) and glycated hemoglobin (HbA1c). Because it reflects the current status of hyperglycemia, urinary myo-inositol (UMI) may be useful. We evaluated UMI as a screening tool for glucose intolerance.

DESIGN AND METHODS

A cross-sectional, community-based population study of 1057 Japanese residents. 173 with an FPG level between 5.5 and 6.9 mmol/L and an HbA1c under 6.5% had an oral glucose tolerance test. We measured UMI level before (fasting UMI) and 2h after (2h-UMI) glucose ingestion. Δ-UMI was defined as the difference between fasting UMI and 2h-UMI.

RESULTS

Δ-UMI, 2h-UMI and HbA1c levels significantly increased as glucose intolerance worsened. Δ-UMI level was significantly positively correlated with 2h-UMI level (r=0.896, p<0.001). Using cutoff levels from receiver operating characteristic (ROC) analyses, the sensitivity of Δ-UMI (82.1%) and 2h-UMI (79.3%) were higher than that of HbA1c (48.3%). The area under the ROC curve values for Δ-UMI (0.903) and 2h-UMI (0.891) were higher than that for HbA1c (0.785).

CONCLUSIONS

2h-UMI is useful as a non-invasive screening of glucose intolerance.

摘要

目的

用于检测葡萄糖耐量异常的最常见的筛查试验为空腹血糖（FPG）和糖化血红蛋白（HbA1c）。由于它反映了当前的高血糖状态，尿肌醇（UMI）可能是有用的。我们评估了 UMI 作为葡萄糖耐量异常的筛查工具。

设计和方法

这是一项横断面、基于社区的人群研究，共纳入了 1057 名日本居民。其中 173 名居民的 FPG 水平在 5.5 至 6.9mmol/L 之间，HbA1c 水平<6.5%，进行了口服葡萄糖耐量试验。我们在葡萄糖摄入前（空腹 UMI）和 2 小时后（2h-UMI）测量了 UMI 水平。Δ-UMI 定义为空腹 UMI 与 2h-UMI 之间的差值。

结果

Δ-UMI、2h-UMI 和 HbA1c 水平随着葡萄糖耐量的恶化而显著升高。Δ-UMI 水平与 2h-UMI 水平呈显著正相关（r=0.896，p<0.001）。根据受试者工作特征（ROC）分析的截断值，Δ-UMI（82.1%）和 2h-UMI（79.3%）的敏感性高于 HbA1c（48.3%）。ROC 曲线下面积值方面，Δ-UMI（0.903）和 2h-UMI（0.891）均高于 HbA1c（0.785）。