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新冠大流行前后筛查的儿童和青少年基于 1 小时负荷后血浆葡萄糖的肥胖相关并发症包括血糖异常。

Obesity-Related Complications Including Dysglycemia Based on 1-h Post-Load Plasma Glucose in Children and Adolescents Screened before and after COVID-19 Pandemic.

机构信息

Department of Pediatrics, Diabetology, Endocrinology and Nephrology, Medical University of Lodz, 90-419 Lodz, Poland.

Department of Pediatrics, Endocrinology, Diabetology and Nephrology, Central Clinical Hospital of Medical University of Lodz, 90-419 Lodz, Poland.

出版信息

Nutrients. 2024 Aug 5;16(15):2568. doi: 10.3390/nu16152568.

Abstract

Childhood obesity, with its metabolic complications, is a problem of public health. The International Diabetes Federation (IDF) has recommended glucose levels 1 h post oral glucose load (1h-PG) > 155-209 mg/dL as diagnostic for intermediate hyperglycemia (IH), while >209 mg/dL for type 2 diabetes (T2D). The aim of the study was to assess the occurrence of prediabetes, IH, and T2D in children and adolescents with simple obesity according to the criteria of American Diabetes Association (ADA) and of IDF, and the effect of COVID-19 pandemic on these disorders. Analysis included 263 children with simple obesity, screened either in prepandemic (PRE-113 cases) or post-pandemic period (POST-150 cases). All children underwent 2 h OGTT with measurements of glucose and insulin every 0.5 h, lipid profile, and other tests; indices if insulin resistance (IR): HOMA, QUICKI, Matsuda index, AUC (glu/ins) were calculated. The incidence of T2D, prediabetes, and IH was higher in POST with respect to PRE, with significant differences in the indices of IR, except for HOMA. Significant differences were observed in the assessed parameters of glucose metabolism among the groups with T2D, prediabetes, IH, and normal glucose tolerance (NGT), with some similarities between IH (based on 1h-PG) and prediabetes. Increased frequency of dysglycemia among children and adolescents with simple obesity is observed after COVID-19 pandemic. Metabolic profile of patients with IH at 1h-PG is "intermediate" between NGT and prediabetes.

摘要

儿童肥胖症及其代谢并发症是一个公共卫生问题。国际糖尿病联合会(IDF)建议,口服葡萄糖负荷后 1 小时(1h-PG)血糖水平>155-209mg/dL 用于诊断中间高血糖(IH),而>209mg/dL 用于诊断 2 型糖尿病(T2D)。本研究旨在评估根据美国糖尿病协会(ADA)和 IDF 标准,单纯性肥胖儿童和青少年中糖尿病前期、IH 和 T2D 的发生情况,以及 COVID-19 大流行对这些疾病的影响。分析纳入了 263 例单纯性肥胖儿童,分别在大流行前(PRE-113 例)和大流行后(POST-150 例)进行筛查。所有儿童均接受 2 小时 OGTT,每 0.5 小时测量血糖和胰岛素,检测血脂谱和其他指标;计算胰岛素抵抗(IR)的指数:HOMA、QUICKI、Matsuda 指数、AUC(glu/ins)。与 PRE 相比,POST 组的 T2D、糖尿病前期和 IH 的发生率更高,除 HOMA 外,IR 指数也有显著差异。T2D、糖尿病前期、IH 和正常糖耐量(NGT)组之间葡萄糖代谢评估参数存在显著差异,IH(基于 1h-PG)和糖尿病前期之间存在一些相似性。COVID-19 大流行后,单纯性肥胖儿童和青少年的糖调节异常频率增加。1h-PG 时 IH 患者的代谢特征在 NGT 和糖尿病前期之间“处于中间”。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c3fa/11314267/391686e23b0a/nutrients-16-02568-g001.jpg

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