Department of Internal Medicine, Hokuriku Central Hospital, Kanazawa University Hospital, Kanazawa, Japan.
Department of Cardiovascular and Internal Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Japan.
J Diabetes Res. 2017;2017:5307523. doi: 10.1155/2017/5307523. Epub 2017 Sep 14.
We aimed to clarify how the trajectories of 1-hour postload plasma glucose (PG) and 2-hour PG were different in the development of type 2 diabetes. Using data of repeated health checkups in Japanese workers from April 2006 to March 2016, longitudinal changes of fasting, 1-hour, and 2-hour PG on the oral glucose tolerance test were analyzed with a linear mixed effects model. Of the 1464 nondiabetic subjects at baseline, 112 subjects progressed to type 2 diabetes during the observation period (progressors). In progressors, 1-hour PG and 2-hour PG showed gradual increases with slopes of 1.33 ± 0.2 and 0.58 ± 0.2 mg/dL/year, respectively, followed by a steep increase by which they attained diabetes. Until immediately before the diabetes transition, age- and sex-adjusted mean level of 2-hour PG was 149 ± 2.7 mg/dL, 34 ± 2.7 (30%) higher compared to nonprogressors, while that of 1-hour PG was 206 ± 4.1 mg/dL, 60 ± 4.3 mg/dL (41%) higher compared to nonprogressors. In conclusion, diabetes transition was preceded by a mild elevation of 2-hour PG for several years or more. The elevation in 1-hour PG was larger than that of 2-hour PG until immediately before the transition to diabetes.
我们旨在阐明 1 小时餐后血糖 (PG) 和 2 小时 PG 轨迹在 2 型糖尿病发展过程中的差异。使用 2006 年 4 月至 2016 年 3 月日本工人重复健康检查的数据，通过线性混合效应模型分析口服葡萄糖耐量试验中空腹、1 小时和 2 小时 PG 的纵向变化。在基线时的 1464 名非糖尿病患者中，112 名在观察期间进展为 2 型糖尿病（进展者）。在进展者中，1 小时 PG 和 2 小时 PG 呈逐渐升高趋势，斜率分别为 1.33±0.2 和 0.58±0.2mg/dL/年，随后急剧升高，达到糖尿病水平。在糖尿病转变之前，经年龄和性别调整的 2 小时 PG 平均水平为 149±2.7mg/dL，比非进展者高 34±2.7（30%），而 1 小时 PG 平均水平为 206±4.1mg/dL，比非进展者高 60±4.3mg/dL（41%）。总之，糖尿病转变前，2 小时 PG 会有多年或更长时间的轻度升高。在向糖尿病转变之前，1 小时 PG 的升高幅度大于 2 小时 PG。
