Abdul-Ghani Muhammad, Abu-Farha Mohamed, Abdul-Ghani Tamam, Chavez-Velazquez Alberto, Merovci Auora, DeFronzo Ralph A, Alajmi Fahad, Stern Michael, Al-Mulla Fahd
Diabetes Division, University of Texas Health Science Center at San Antonio, San Antonio, TX.
Translational Research Department, Dasman Diabetes Institute, Dasman, Kuwait.
Diabetes Care. 2025 Jul 1;48(7):1273-1279. doi: 10.2337/dc24-2832.
To examine the ability of the 1-h plasma glucose (PG) concentration during the oral glucose tolerance test (OGTT) to predict the risk of progression to prediabetes in individuals with normal glucose tolerance (NGT).
A total of 1,557 participants from the San Antonio Heart Study who were free of type 2 diabetes at baseline, had a baseline OGTT, and had a repeat OGTT after 7.5 years of follow-up were evaluated. The ability of 1-h PG concentration to predict the development of prediabetes, based on American Diabetes Association criteria, was evaluated.
Approximately one-quarter of participants with NGT (24.7%) progressed to prediabetes at 7.5 years (22.5% with 1-h PG <155 mg/dL and 42.5% with 1-h PG >155 mg/dL). The 1-h PG was the strongest predictor of developing prediabetes, and a 1-h cut point of 120 mg/dL had 61% sensitivity and 67% specificity in identifying individuals with NGT at high risk of developing prediabetes. Participants with a 1-h PG of 120-155 mg/dL and who experienced a deterioration in glucose tolerance (progression to prediabetes) at follow-up were characterized by severe insulin resistance and metabolic abnormalities characteristic of the insulin resistance syndrome. Therefore, we suggest the term pre-prediabetes for this group to emphasize their high future risk of deteriorating glucose tolerance.
An increase in 1-h PG concentration precedes the development of prediabetes and identifies individuals with a 1-h PG of 120-155 mg/dL who are at increased risk of developing prediabetes. Therefore, we suggest the term pre-prediabetes for this group with an elevated risk of deteriorating glucose tolerance.
研究口服葡萄糖耐量试验（OGTT）期间1小时血浆葡萄糖（PG）浓度预测糖耐量正常（NGT）个体进展为糖尿病前期风险的能力。
对圣安东尼奥心脏研究中的1557名参与者进行评估，这些参与者在基线时无2型糖尿病，进行了基线OGTT，并在随访7.5年后进行了重复OGTT。根据美国糖尿病协会标准，评估1小时PG浓度预测糖尿病前期发生的能力。
约四分之一的NGT参与者（24.7%）在7.5年后进展为糖尿病前期（1小时PG<155mg/dL的参与者中有22.5%，1小时PG>155mg/dL的参与者中有42.5%）。1小时PG是发生糖尿病前期的最强预测指标，120mg/dL的切点在识别有发展为糖尿病前期高风险的NGT个体时，敏感性为61%，特异性为67%。1小时PG为120 - 155mg/dL且在随访中糖耐量恶化（进展为糖尿病前期）的参与者，其特征为严重胰岛素抵抗和胰岛素抵抗综合征的代谢异常。因此，我们建议将该组称为糖尿病前期前期，以强调其未来糖耐量恶化的高风险。
糖尿病前期的发生之前1小时PG浓度会升高，1小时PG为120 - 155mg/dL的个体发生糖尿病前期的风险增加。因此，我们建议将糖耐量恶化风险升高的该组称为糖尿病前期前期。
