Hanefeld Markolf, Sulk Stefan, Helbig Matthias, Thomas Andreas, Köhler Carsta
Study Centre Prof. Hanefeld, GWT-TUD GmbH, Dresden, Germany
Study Centre Prof. Hanefeld, GWT-TUD GmbH, Dresden, Germany.
J Diabetes Sci Technol. 2014 Mar;8(2):286-290. doi: 10.1177/1932296814522739. Epub 2014 Mar 2.
So far the criteria for NGT and abnormal glucose tolerance (AGT) are based on HbA1c and 75 g oGTT. We present data on GV and diurnal profiles in stratified cohorts with AGT versus controls. 28 NGT, 42 AGT (15 IGT, 11 IFG, 16 CGI) matched for age and BMI classified by 75 g oGTT underwent a CGM with test meal (TM). Diurnal profiles, glucose excursion after TM, and GV (SD, MAGE) were calculated for day 2 and 3. HbA1c, with its values of 5.5 ± 0.37% versus 5.65 ± 0.36%, was within normal range. Average interstitial glucose (AiG) was 5.84 ± 0.52 mmol/l) in NGT and 6.35 ± 0.65 mmol/l in AGT (P = .002). The 2 h incremental area under curve (iAUC) from TM until 2 h after TM was 1.94 ± 1.31 mmol/lh versus 2.89 ( ± 1.75) mmol/lh (P = .012), AiG 2 hours after TM was 5.99 ± 1.14 mmol/ld versus 6.64 ± 1.30 mmol/l (P = .035). Peaks of AiG after TM were 7.69 ± 1.48 mmol/ld versus 9.18 ± 1.67 mmol/l*d (P = .001). SD was significantly higher for AGT (1.12 ± 0.37 vs. 0.85 ± 0.32 mmol/l, P = .01) and MAGE 2.26 ± 0.84 vs. 1.60 ± 0.69 mmol/l, P = .005). In this comparative analysis NGT and AGT well matched for age, BMI, and comorbidities, CGM revealed significant differences in daytime AiG, pp glucose excursion and postprandial peaks. SD and MAGE was significantly higher for subjects with AGT. I Impaired glucose homeostasis a better characterizes degree of AGTe than HbA1c and 75 g OGTT.
到目前为止,正常糖耐量(NGT)和异常糖耐量(AGT)的标准是基于糖化血红蛋白(HbA1c)和75克口服葡萄糖耐量试验(oGTT)。我们展示了AGT分层队列与对照组的血糖变异性(GV)和昼夜血糖谱数据。28例NGT患者、42例AGT患者(15例糖耐量受损[IGT]、11例空腹血糖受损[IFG]、16例化学性血糖不稳定[CGI]),根据75克oGTT按年龄和体重指数(BMI)匹配,接受了含试验餐(TM)的连续血糖监测(CGM)。计算了第2天和第3天的昼夜血糖谱、试验餐后的血糖波动以及GV(标准差[SD]、平均血糖波动幅度[MAGE])。HbA1c值分别为5.5±0.37%和5.65±0.36%,均在正常范围内。NGT组的平均组织间液葡萄糖(AiG)为5.84±0.52毫摩尔/升,AGT组为6.35±0.65毫摩尔/升(P = 0.002)。从试验餐到试验餐后2小时的2小时曲线下增量面积(iAUC)分别为1.94±1.31毫摩尔/升·小时和2.89(±1.75)毫摩尔/升·小时(P = 0.012),试验餐后2小时的AiG分别为5.99±1.14毫摩尔/升·天和6.64±1.30毫摩尔/升(P = 0.035)。试验餐后AiG的峰值分别为7.69±1.48毫摩尔/升·天和9.18±1.67毫摩尔/升·天(P = 0.001)。AGT组的SD显著更高(1.12±0.37对0.85±0.32毫摩尔/升,P = 0.01),MAGE分别为2.26±0.84和1.60±0.69毫摩尔/升,P = 0.005)。在这项对比分析中,NGT组和AGT组在年龄、BMI和合并症方面匹配良好,CGM显示白天AiG、餐后血糖波动和餐后峰值存在显著差异。AGT受试者的SD和MAGE显著更高。与HbA1c和75克口服葡萄糖耐量试验相比,葡萄糖稳态受损能更好地表征AGT的程度。