Zhang Han, Tang Hanqing, Gu Yunjuan, Tang Zhuqi, Zhao Xiaoqin, Zhou Ranran, Huang Ping, Zhang Rongping, Wang Xinlei
Department of Endocrinology and Metabolism, Affiliated Hospital of Nantong University, Nantong, Jiangsu, China.
Nantong University, Nantong, Jiangsu, China.
J Diabetes Investig. 2025 Feb;16(2):236-245. doi: 10.1111/jdi.14382. Epub 2024 Dec 17.
To explore the relationships between the delayed monophasic glucose peak during oral glucose tolerance test (OGTT) and early-stage diabetic nephropathy (DN) in patients with type 2 diabetes mellitus(T2DM), and to speculate its potential as a risk factor for early-stage DN.
This retrospective observational study included 448 participants, all of whom underwent a 3-h OGTT. Based on peak glucose time, they were categorized into the normal glucose tolerance (NGT) group (n = 76), the early delayed group (n = 98), and the late delayed group (n = 274) for comparison. Furthermore, T2DM patients were subdivided into the non-DN group (n = 293) and the early-stage DN group (n = 79) for comparative analysis.
With the delay in glucose peak time, blood glucose levels increased, insulin secretion function and insulin sensitivity decreased. In logistic regression, ISSI-2 was independently associated with the delay in glucose peak time in patients with T2DM (OR 0.839; 95% CI 0.776-0.907; P < 0.001). Additionally, 2-h plasma glucose, OGIS, and AUC were independently associated with delayed peak glucose time (all P < 0.001). As glucose peak time was delayed, levels of β2-microglobulin and UACR increased, and the prevalence of early-stage DN also increased (all P < 0.050). The delayed monophasic glucose peak was positively associated with early-stage DN (OR 2.230; 95% CI 1.061-4.687; P = 0.034).
In patients with T2DM, the delayed monophasic glucose peak during OGTT may be an early predictor of early-stage diabetes nephropathy, providing early intervention signals for our clinical work.
探讨2型糖尿病（T2DM）患者口服葡萄糖耐量试验（OGTT）中延迟的单相血糖峰值与早期糖尿病肾病（DN）之间的关系，并推测其作为早期DN危险因素的可能性。
这项回顾性观察性研究纳入了448名参与者，他们均接受了3小时的OGTT。根据血糖峰值时间，将他们分为正常糖耐量（NGT）组（n = 76）、早期延迟组（n = 98）和晚期延迟组（n = 274）进行比较。此外，将T2DM患者细分为非DN组（n = 293）和早期DN组（n = 79）进行对比分析。
随着血糖峰值时间延迟，血糖水平升高，胰岛素分泌功能和胰岛素敏感性降低。在逻辑回归分析中，ISSI-2与T2DM患者血糖峰值时间延迟独立相关（OR 0.839；95%CI 0.776 - 0.907；P < 0.001）。此外，2小时血浆葡萄糖、OGIS和AUC与血糖峰值时间延迟独立相关（均P < 0.001）。随着血糖峰值时间延迟，β2-微球蛋白和UACR水平升高，早期DN的患病率也增加（均P < 0.050）。延迟的单相血糖峰值与早期DN呈正相关（OR 2.230；95%CI 1.061 - 4.687；P = 0.034）。
在T2DM患者中，OGTT期间延迟的单相血糖峰值可能是早期糖尿病肾病的早期预测指标，为我们的临床工作提供早期干预信号。
