Bergman Michael, Chetrit Angela, Roth Jesse, Jagannathan Ram, Sevick Mary, Dankner Rachel
NYU School of Medicine, Department of Medicine, Division of Endocrinology and Metabolism, NYU Langone Diabetes Prevention Program, 530 First Avenue, Schwartz East, Suite 5E, New York, NY 10016, USA.
Unit for Cardiovascular Epidemiology, The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer 52621, Israel.
Diabetes Res Clin Pract. 2016 Oct;120:221-8. doi: 10.1016/j.diabres.2016.08.013. Epub 2016 Aug 26.
The present study assessed the longitudinal association of an elevated 1-h plasma glucose [1-h-PG >8.6mmol/l (155mg/dl)] with and without impaired glucose tolerance [IGT; 2-h-PG 7.8-11.0mmol/l (140-199mg/dl)] with cumulative incident of diabetes and prediabetes over 24years in a non-diabetic cohort.
From 1979 to 1984, 1970 non-diabetic men and women completed an oral glucose tolerance test (OGTT), physical and biochemical measurements as well as a questionnaire related to lifestyle and medical background. During the years 2000-2004, 853 survivors of the original cohort were interviewed and re-examined for glycemic progression.
Individuals with 1-h-PG >8.6mmol/l (155mg/dl) but with 2-h-PG <7.8mmol/l (140mg/dl) had a significantly elevated risk, compared to those with both 1-h-PG ⩽8.6mmol/l (155mg/dl) and 2-h-PG <7.8mmol/l (140mg/dl), for both diabetes [OR:4.35 (95%CI: 2.50-7.73)] and prediabetes outcomes [OR:1.87 (95%CI 1.09-3.26)], adjusted for sex and age, smoking, body mass index, blood pressure, fasting blood glucose and insulin.
The risk for diabetes associated with a 1-h level >8.6mmol/l (155mg/dl) is increased and further worsened in the presence of IGT. Identifying individuals at risk with a 1-h-PG glucose level during an OGTT is recommended.
本研究评估了在一个非糖尿病队列中,1小时血浆葡萄糖升高[1小时血糖>8.6mmol/l(155mg/dl)]且伴有或不伴有糖耐量受损[IGT;2小时血糖7.8 - 11.0mmol/l(140 - 199mg/dl)]与24年间糖尿病和糖尿病前期累积发病率之间的纵向关联。
1979年至1984年,1970名非糖尿病男性和女性完成了口服葡萄糖耐量试验(OGTT)、体格和生化测量以及一份与生活方式和医疗背景相关的问卷。在2000年至2004年期间,对原队列中的853名幸存者进行了访谈,并重新检查了血糖进展情况。
与1小时血糖≤8.6mmol/l(155mg/dl)且2小时血糖<7.8mmol/l(140mg/dl)的个体相比,1小时血糖>8.6mmol/l(155mg/dl)但2小时血糖<7.8mmol/l(140mg/dl)的个体患糖尿病[比值比:4.35(95%置信区间:2.50 - 7.73)]和糖尿病前期结局[比值比:1.87(95%置信区间1.09 - 3.26)]的风险显著升高,对性别、年龄、吸烟、体重指数、血压、空腹血糖和胰岛素进行了校正。
1小时血糖水平>8.6mmol/l(155mg/dl)与糖尿病相关的风险增加,并且在存在IGT的情况下会进一步恶化。建议在OGTT期间通过1小时血糖水平识别有风险的个体。