Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
Department of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
J Investig Med. 2021 Jun;69(5):1044-1049. doi: 10.1136/jim-2020-001646. Epub 2021 Feb 1.
We investigated the association between postchallenge glucose increment and hemoglobin glycation index (HGI), the difference between observed and predicted glycated hemoglobin (HbA1c), in subjects with no history of diabetes. We enrolled 1381 subjects who attended our outpatient clinic for an oral glucose tolerance test (OGTT) to screen for diabetes. HGI was defined as observed HbA1c minus predicted HbA1c. The predicted HbA1c was calculated by entering fasting plasma glucose (FPG) level into an equation [HbA1c(%)=FPG(mg/dL)*0.029+2.9686] determined from an HbA1c versus FPG regression analysis using data from an independent cohort of 2734 subjects with no history of diabetes. The association between 2-hour glucose increment and HGI was analyzed using linear regression analyses with adjustment of relevant parameters. Overall, the proportions of subjects with normal glucose tolerance, pre-diabetes, and newly diagnosed diabetes were 42.3%, 41.3%, and 16.4%, respectively. Compared with subjects who had an HGI≤0, subjects with an HGI>0 had a lower FPG (95.0±13.3 vs 98.5±15.3 mg/dL, p<0.001) but a higher 2-hour plasma glucose (151.1±52.8 vs 144.6±51.4 mg/dL, p=0.027) and 2-hour glucose increment (56.1±46.1 vs 46.1±45.0 mg/dL, p<0.001). The 2-hour glucose increment after an OGTT was independently associated with HGI (β coefficient 0.003, 95% CI 0.002 to 0.003, p<0.001). Our findings suggested that postchallenge glucose increment was independently associated with HGI in subjects with no history of diabetes.
我们研究了无糖尿病病史受试者中，口服葡萄糖耐量试验（OGTT）后血糖增量与血红蛋白糖化指数（HGI）、实际糖化血红蛋白（HbA1c）与预测糖化血红蛋白（HbA1c）差值之间的相关性。我们纳入了 1381 名在我院门诊行 OGTT 以筛查糖尿病的受试者。HGI 定义为实际 HbA1c 与预测 HbA1c 差值。预测 HbA1c 通过将空腹血浆葡萄糖（FPG）水平代入到由 2734 名无糖尿病病史受试者的 HbA1c 与 FPG 回归分析所确定的方程[HbA1c（%）=FPG（mg/dL）×0.029+2.9686]中得出。采用线性回归分析，在调整了相关参数后，分析了 2 小时血糖增量与 HGI 的相关性。总体而言，正常糖耐量、糖尿病前期和新诊断糖尿病患者的比例分别为 42.3%、41.3%和 16.4%。与 HGI≤0 的患者相比，HGI>0 的患者 FPG 较低（95.0±13.3 vs. 98.5±15.3mg/dL，p<0.001），但 2 小时血浆葡萄糖（151.1±52.8 vs. 144.6±51.4mg/dL，p=0.027）和 2 小时血糖增量（56.1±46.1 vs. 46.1±45.0mg/dL，p<0.001）较高。OGTT 后 2 小时血糖增量与 HGI 独立相关（β系数 0.003，95%CI 0.002-0.003，p<0.001）。我们的研究结果表明，无糖尿病病史受试者中，OGTT 后血糖增量与 HGI 独立相关。
