Department of Endocrinology and Diabetes, Toyooka Public Hospital, 1094 Tobera, Toyooka 668-8501, Japan.
Environment and Total Quality Management Division, NEC Corporation, 5-7-1 Minato-ku, Shiba, Tokyo 108-0014, Japan.
Nutrients. 2021 Sep 2;13(9):3092. doi: 10.3390/nu13093092.
Data regarding hyperglycemia-related factors were scarce in people without diabetes. Fifty males (age 50-65 years) with overweight/obesity but without diagnosis of diabetes were recruited. After excluding participants with the 2 h plasma glucose value during a 75 g oral glucose tolerance test ≥200 mg/dL, continuous glucose monitoring (CGM) was performed for 6 days. Subjects with ≥1800 CGM readings were included ( = 36). The CGM indices of hyperglycemia were significantly associated with disposition index and snacking frequency. In receiver-operating characteristic analysis for predicting the maximal CGM glucose ≥200 mg/dL, the area under curves of disposition index, snacking frequency, and minimal daily step counts during the study were 0.69, 0.63, and 0.68, whereas the cutoff values were 1.57, once daily, and 2499 steps, respectively. After adjustments, the lower disposition index (≤1.57), higher snacking frequency (≥1 per day), and lower minimal step (≤2499 steps per day) categories conferred 14.5, 14.5, and 6.6-fold increased probabilities for having the maximum level ≥ 200 mg/dL, respectively. In addition, the snacking habits were significantly associated with insulin resistance and compensatory hyperinsulinemia. In conclusion, in middle aged males with overweight/obesity but without diabetes, snacking and physical inactivity serve as the major drivers of postprandial hyperglycemia independently of β-cell function.
数据表明,在非糖尿病患者中,与高血糖相关的因素较为匮乏。研究招募了 50 名年龄在 50-65 岁之间、超重/肥胖但未被诊断为糖尿病的男性。在排除了口服葡萄糖耐量试验 2 小时血浆葡萄糖值≥200mg/dL 的参与者后,对他们进行了为期 6 天的连续血糖监测(CGM)。共纳入了≥1800 次 CGM 读数的受试者(n=36)。CGM 高血糖指数与处置指数和零食频率显著相关。在预测最大 CGM 血糖值≥200mg/dL 的受试者工作特征分析中,处置指数、零食频率和研究期间最小每日步数的曲线下面积分别为 0.69、0.63 和 0.68,而截断值分别为 1.57、每天一次和 2499 步。调整后,较低的处置指数(≤1.57)、较高的零食频率(≥1 次/天)和较低的最小步数(≤2499 步/天)类别分别使最大水平≥200mg/dL 的发生概率增加了 14.5、14.5 和 6.6 倍。此外,零食习惯与胰岛素抵抗和代偿性高胰岛素血症显著相关。总之,在超重/肥胖但无糖尿病的中年男性中,零食和身体活动不足是餐后高血糖的主要驱动因素,独立于β细胞功能。