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评价肥胖儿童和青少年口服葡萄糖耐量试验中 1 小时血浆葡萄糖浓度与胰岛β细胞功能和心血管代谢参数的关系。

Evaluation of the relationship between the one-hour plasma glucose concentration and beta-cell functions and cardiometabolic parameters during oral glucose tolerance test in obese children and adolescents.

机构信息

Department of Pediatric Endocrinology, Ankara City Hospital, Children's Hospital, Ankara, Turkey.

出版信息

J Pediatr Endocrinol Metab. 2020 May 24;33(6):767-775. doi: 10.1515/jpem-2020-0016.

DOI:10.1515/jpem-2020-0016
PMID:32447335
Abstract

Background In this study, we aimed to evaluate the relationship between the 1-h plasma glucose (PG) level in the oral glucose tolerance test (OGTT) and conventional glycemic parameters, indices evaluating beta-cell functions, and cardiometabolic risk factors. Methods The records of 532 obese patients who were followed up in the Pediatric Endocrinology Polyclinic and who underwent standard OGTT were evaluated retrospectively. All patients were divided into two groups according to OGTT data as the 1-h plasma glucose concentration <155 mg/dL (n=329) and ≥155 mg/dL (n=203). Patients with normal glucose tolerance (NGT) were divided into two groups according to the 1-h PG level, as 218 patients with NGT 1 h-low (<155 mg/dL) and 53 patients with high NGT 1 h-high (≥155 mg/dL). Results There was a statistically significant difference between the lipid profiles of individuals with NGT 1 h-low (<155 mg/dL) and individuals with NGT 1 h-high (≥155 mg/dL) (p<0.001). Total cholesterol, LDL cholesterol, and triglyceride levels were higher, while HDL cholesterol levels were lower in individuals with NGT 1 h-high (≥155 mg/dL). The indices evaluating beta-cell functions were significantly higher in individuals with NGT 1 h-low (<155 mg/dL). Conclusion As a result, a plasma glucose concentration above or equal to 155 mg/dL at 1 h during an OGTT is associated with a worse clinical phenotype characterized by changes in insulin sensitivity and β-cell function. Therefore, this threshold value can predict the progression of prediabetes in obese young people with NGT.

摘要

背景 在这项研究中,我们旨在评估口服葡萄糖耐量试验(OGTT)中 1 小时血浆葡萄糖(PG)水平与常规血糖参数、β细胞功能评估指标以及心血管代谢危险因素之间的关系。

方法 回顾性分析了在儿科内分泌科就诊并接受标准 OGTT 的 532 例肥胖患者的记录。根据 OGTT 数据,所有患者分为两组:1 小时血浆葡萄糖浓度<155mg/dL(n=329)和≥155mg/dL(n=203)。根据 1 小时 PG 水平,将糖耐量正常(NGT)患者进一步分为两组:218 例 NGT 1 小时低(<155mg/dL)和 53 例 NGT 1 小时高(≥155mg/dL)。

结果 NGT 1 小时低(<155mg/dL)和 NGT 1 小时高(≥155mg/dL)患者的血脂谱存在显著差异(p<0.001)。NTG 1 小时高(≥155mg/dL)患者的总胆固醇、LDL 胆固醇和甘油三酯水平较高,而高密度脂蛋白胆固醇水平较低。NGT 1 小时低(<155mg/dL)患者的β细胞功能评估指标明显较高。

结论 因此,OGTT 1 小时时血浆葡萄糖浓度≥155mg/dL 与胰岛素敏感性和β细胞功能变化的更差临床表型相关。因此,该阈值可预测糖耐量正常的肥胖年轻人中糖尿病前期的进展。

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