1 Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.
2 University of Cambridge School of Clinical Medicine, Cambridge, UK.
Diab Vasc Dis Res. 2019 Jul;16(4):337-343. doi: 10.1177/1479164119827239. Epub 2019 Feb 13.
The aim of this study was to gain insight into the pathophysiological significance of elevated plasma glucose concentrations (mmol/L) 60 min post oral glucose load in apparently healthy individuals.
Comparison of resistance to insulin action and associated cardio-metabolic risk factors in 490 apparently healthy persons, subdivided into those with a plasma glucose concentration 60 min following a 75-g oral glucose challenge of <8.6 versus ⩾8.6.
Insulin resistance was significantly greater in persons with normal glucose tolerance whose 60-min glucose concentration was ⩾8.6, associated with higher blood pressure, plasma concentrations of glucose, insulin, triglyceride and lower high-density lipoprotein cholesterol concentrations. Similar differences were seen in persons with impaired fasting glucose, but not in those with impaired glucose tolerance or both impaired fasting glucose and impaired glucose tolerance. The group whose 60-min glucose was <8.6 ( = 318) contained primarily persons with normal glucose tolerance (88%), whereas the majority of those whose 60-min value was ⩾8.6 ( = 172) had prediabetes (59%) and in particular combined impaired fasting glucose and impaired glucose tolerance.
Plasma glucose concentration of ⩾8.6 mmol/L 60 min post oral glucose identifies higher proportions of combined impaired fasting glucose and impaired glucose tolerance individuals as well as normal glucose tolerance and impaired fasting glucose individuals with a more adverse cardio-metabolic profile, contributing to observed increased overall risk of type 2 diabetes and other metabolic diseases.
本研究旨在深入了解口服葡萄糖负荷后 60 分钟时血浆葡萄糖浓度（mmol/L）升高在貌似健康个体中的病理生理意义。
比较 490 名貌似健康个体的胰岛素抵抗情况及相关心血管代谢危险因素，这些个体根据口服 75g 葡萄糖后 60 分钟时的血浆葡萄糖浓度分为<8.6 与⩾8.6 两组。
糖耐量正常但 60 分钟血糖浓度⩾8.6 的个体胰岛素抵抗明显更严重，同时伴有血压升高、血糖、胰岛素、甘油三酯浓度升高和高密度脂蛋白胆固醇浓度降低。空腹血糖受损者也存在类似差异，但葡萄糖耐量受损者或两者兼有者则没有。60 分钟血糖<8.6（n=318）的个体主要为糖耐量正常者（88%），而 60 分钟血糖⩾8.6（n=172）的个体中多数患有糖尿病前期（59%），尤其是同时存在空腹血糖受损和葡萄糖耐量受损者。
口服葡萄糖负荷后 60 分钟时的血糖浓度⩾8.6mmol/L 可识别出更多同时存在空腹血糖受损和葡萄糖耐量受损以及糖耐量正常和空腹血糖受损的个体，这些个体具有更不利的心血管代谢特征，导致观察到的 2 型糖尿病和其他代谢性疾病的总体风险增加。
