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.
Diabetes Res Clin Pract. 2014 Jan;103(1):88-96. doi: 10.1016/j.diabres.2013.11.018. Epub 2013 Dec 4.
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.
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.
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).
2h-UMI is useful as a non-invasive screening of glucose intolerance.
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。
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。
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）。
2h-UMI 可作为葡萄糖耐量异常的非侵入性筛查方法。
