Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Department of Occupational and Environmental Medicine, College of Medicine, Kyung Hee University, Seoul.
J Clin Endocrinol Metab. 2019 Feb 1;104(2):539-549. doi: 10.1210/jc.2018-01102.
Metabolic syndrome (MetS) increases the cardiometabolic risk even in nondiabetic patients. Previous studies have demonstrated that 1-hour postload glucose (PG) and 2-hour PG based on oral glucose tolerance test (OGTT) predicted cardiometabolic risk. However, it is still unclear whether and to what extent postload glucose is associated with the risk of MetS.
A total of 5389 nondiabetic Koreans were dichotomized into normoglycemic (NG) groups and abnormal glycemic groups based on OGTT, including elevated 1-hour PG (155 to 199 mg/dL) and impaired glucose tolerance (IGT) (2-hour PG 140 to 199 mg/dL), and followed up for 10 years. Cox proportional hazard model was used to evaluate hazard ratios (HRs) with 95% CIs for incident MetS. Subgroups were determined by high or normal 1-hour PG (cutoff: 155 mg/dL) and 2-hour PG (cutoff: 140 mg/dL).
Compared with NG, the risk of MetS increased proportionally to the level of 1-hour PG and 2-hour PG, independently of the number of baseline metabolic components. Even within people with normoglycemia, elevated PG above specific levels (1-hour PG ≥115 mg/dL and 2-hour PG ≥100 mg/dL) was significantly associated with the increased risk of MetS. In subgroup analysis, adjusted HR for MetS was higher in the group with high 1-hour PG and normal 2-hour PG [1.53 (95% CI, 1.35 to 1.74)] than in the group with normal 1-hour PG and high 2-hour PG [1.32 (95% CI, 1.02 to 1.70)].
Elevated 1-hour PG and 2-hour PG significantly are associated with greater risk for MetS, and 1-hour PG was superior to 2-hour PG in predicting MetS.
代谢综合征（MetS）即使在非糖尿病患者中也会增加心血管代谢风险。先前的研究表明，口服葡萄糖耐量试验（OGTT）1 小时后血糖（PG）和 2 小时 PG 可预测心血管代谢风险。然而，目前尚不清楚餐后血糖与 MetS 风险之间的关系以及程度如何。
总共纳入了 5389 名非糖尿病韩国人，根据 OGTT 将其分为血糖正常（NG）组和异常血糖组，包括高 1 小时 PG（155 至 199mg/dL）和糖耐量受损（IGT）（2 小时 PG 140 至 199mg/dL），随访 10 年。采用 Cox 比例风险模型评估发生 MetS 的风险比（HR）及其 95%置信区间（CI）。根据高或正常的 1 小时 PG（切点：155mg/dL）和 2 小时 PG（切点：140mg/dL）确定亚组。
与 NG 相比，1 小时 PG 和 2 小时 PG 水平与 MetS 风险呈比例增加，与基线代谢成分的数量无关。即使在血糖正常的人群中，高于特定水平的 PG 升高（1 小时 PG≥115mg/dL 和 2 小时 PG≥100mg/dL）也与 MetS 风险增加显著相关。在亚组分析中，与正常 1 小时 PG 和高 2 小时 PG 组相比，高 1 小时 PG 和正常 2 小时 PG 组的 MetS 调整后 HR 更高[1.53（95%CI，1.35 至 1.74）]，[1.32（95%CI，1.02 至 1.70）]。
升高的 1 小时 PG 和 2 小时 PG 与 MetS 风险增加显著相关，且 1 小时 PG 在预测 MetS 方面优于 2 小时 PG。
