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糖尿病患者的口服葡萄糖耐量试验:旧方法再探讨

Oral glucose tolerance test in diabetes, the old method revisited.

作者信息

Kuo Feng Yu, Cheng Kai-Chun, Li Yingxiao, Cheng Juei-Tang

机构信息

Cardiovascular Center, Veterans General Hospital, Kaohsiung 82445, Taiwan.

Department of Pharmacy, College of Pharmacy and Health Care, Tajen University, Pingtung 90741, Taiwan.

出版信息

World J Diabetes. 2021 Jun 15;12(6):786-793. doi: 10.4239/wjd.v12.i6.786.

Abstract

The oral glucose tolerance test (OGTT) has been widely used both in clinics and in basic research for a long time. It is applied to diagnose impaired glucose tolerance and/or type 2 diabetes mellitus in individuals. Additionally, it has been employed in research to investigate glucose utilization and insulin sensitivity in animals. The main aim of each was quite different, and the details are also somewhat varied. However, the time or duration of the OGTT was the same, using the 2-h post-glucose load glycemia in both, following the suggestions of the American Diabetes Association. Recently, the use of 30-min or 1-h post-glucose load glycemia in clinical practice has been recommended by several studies. In this review article, we describe this new view and suggest perspectives for the OGTT. Additionally, quantification of the glucose curve in basic research is also discussed. Unlike in clinical practice, the incremental area under the curve is not suitable for use in the studies involving animals receiving repeated treatments or chronic treatment. We discuss the potential mechanisms in detail. Moreover, variations between bench and bedside in the application of the OGTT are introduced. Finally, the newly identified method for the OGTT must achieve a recommendation from the American Diabetes Association or another official unit soon. In conclusion, we summarize the recent reports regarding the OGTT and add some of our own perspectives, including machine learning and others.

摘要

口服葡萄糖耐量试验(OGTT)长期以来在临床和基础研究中都得到了广泛应用。它用于诊断个体的糖耐量受损和/或2型糖尿病。此外,它还被用于研究动物的葡萄糖利用和胰岛素敏感性。每项应用的主要目的截然不同,细节也有所差异。然而,按照美国糖尿病协会的建议,OGTT的时间或时长是相同的,两者均采用葡萄糖负荷后2小时血糖值。最近,多项研究建议在临床实践中采用葡萄糖负荷后30分钟或1小时血糖值。在这篇综述文章中,我们阐述了这一新观点,并提出了关于OGTT的展望。此外,还讨论了基础研究中葡萄糖曲线的量化问题。与临床实践不同,曲线下增量面积不适用于涉及接受重复治疗或长期治疗动物的研究。我们详细讨论了潜在机制。此外,还介绍了OGTT在基础研究和临床应用中的差异。最后,新确定的OGTT方法必须尽快获得美国糖尿病协会或其他官方机构的推荐。总之,我们总结了近期关于OGTT的报告,并加入了我们自己的一些观点,包括机器学习等方面。

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