Health Sciences University, Bagcılar Training and Research Hospital, Department of Pediatric Endocrinology, Turkey.
Health Sciences University, Bagcılar Training and Research Hospital, Department of Radiology, Turkey.
Obes Res Clin Pract. 2020 Mar-Apr;14(2):136-141. doi: 10.1016/j.orcp.2020.02.001. Epub 2020 Feb 13.
Evidence suggests that the 1-h post-load plasma glucose (1-h PG) ≥155mg/dL during an oral glucose tolerance test (OGTT) predicts development of type 2 diabetes (T2DM) and associated complications, among adults with normal glucose tolerance (NGT), but relevant data on children is scarce.
To investigate whether NGT children with obesity whose 1-h PG is ≥155mg/dL have an increased carotid intima-media thickness (IMT) and exhibit non-alcoholic fatty liver disease (NAFLD) diagnosed by ultrasonography, as compared with NGT subjects with 1-h PG <155mg/dL and impaired glucose tolerance (IGT).
Cardio-metabolic profile, OGTT, measurements of carotid IMT and liver ultrasonography were analyzed in 171 non-diabetic children with obesity. Subjects were divided into 3 groups: NGT subjects with a 1-h PG <155mg/dL, NGT subjects with a 1-h PG ≥155mg/dL, and IGT subjects.
As compared with NGT individuals with a 1-h PG <155mg/dL, NGT individuals with a 1-h PG ≥155mg/dL exhibited higher carotid IMT (0.75±0.15mm vs. 0.68±0.15mm; p<0.05). No significant differences were observed in carotid IMT between IGT and NGT subjects with a 1-h PG ≥155mg/dL (0.75±0.18mm vs 0.75±0.15mm; p>0.05). Of the three glycemic parameters, 1-h and 2-h PG, but not fasting glucose, were significantly correlated with carotid IMT. There were no significant differences for increased risk of having NAFLD between the three groups.
These data suggest that a value of 1-h PG ≥155mg/dL in children and adolescents with obesity is as important as IGT with respect to cardiovascular risks.
证据表明，口服葡萄糖耐量试验（OGTT）1 小时后血浆葡萄糖（1-h PG）≥155mg/dL 可预测糖耐量正常（NGT）成年人中 2 型糖尿病（T2DM）及其相关并发症的发生，但关于儿童的数据却很少。
本研究旨在探讨肥胖的 NGT 儿童中，1 小时后 PG≥155mg/dL 是否比 1 小时后 PG＜155mg/dL 的 NGT 儿童以及葡萄糖耐量受损（IGT）的儿童颈动脉内膜中层厚度（IMT）增加，并伴有超声诊断的非酒精性脂肪肝（NAFLD）。
对 171 例肥胖的非糖尿病儿童进行了心脏代谢特征、OGTT、颈动脉 IMT 测量和肝脏超声检查。将受试者分为 3 组：1 小时后 PG＜155mg/dL 的 NGT 组、1 小时后 PG≥155mg/dL 的 NGT 组和 IGT 组。
与 1 小时后 PG＜155mg/dL 的 NGT 个体相比，1 小时后 PG≥155mg/dL 的 NGT 个体颈动脉 IMT 更高（0.75±0.15mm 与 0.68±0.15mm；p＜0.05）。IGT 与 1 小时后 PG≥155mg/dL 的 NGT 个体之间的颈动脉 IMT 无显著差异（0.75±0.18mm 与 0.75±0.15mm；p＞0.05）。在三种血糖参数中，1 小时和 2 小时 PG 与颈动脉 IMT 呈显著相关，但空腹血糖与颈动脉 IMT 无显著相关。三组之间发生 NAFLD 的风险无显著差异。
这些数据表明，肥胖儿童和青少年中 1 小时 PG 值≥155mg/dL 与 IGT 相比，与心血管风险同样重要。
