Alberti K G
Human Diabetes and Metabolism Research Centre, Newcastle upon Tyne.
Diabet Med. 1996 Nov;13(11):927-37. doi: 10.1002/(SICI)1096-9136(199611)13:11<927::AID-DIA279>3.0.CO;2-E.
Impaired glucose tolerance (IGT) was introduced in 1979 as an intermediate category covering the grey area between unequivocal diabetes mellitus and risk free more normal glucose tolerance. The IGT group included those at high risk of subsequent development of non-insulin-dependent diabetes mellitus (NIDDM) but low risk of specific diabetic complications. Categorisation of subjects as IGT is hampered by the variability of the oral glucose tolerance test, but even those shown to be IGT only once are at increased risk of developing NIDDM. The relative roles of inheritance, fetal undernutrition, and environmental life style factors (physical inactivity and diet) in the aetiology and pathogenesis of IGT are discussed, with all contributing. The prevalence of IGT in different populations has now been widely studied with values ranging from 2 to 25% in adults. Rates of progression to NIDDM also vary widely from 2 to 14% per year. Risk factors for progression are discussed. IGT also carries an increased risk of development of cardiovascular disease (CVD) and forms part of the "metabolic syndrome". The role of insulin resistance as a common aetiological factor is briefly reviewed. Finally, possible means of treatment of IGT are listed with the intent of delaying the onset of diabetes and CVD, which is of obvious clinical importance.
糖耐量受损（IGT）于1979年被提出，作为一个中间类别，涵盖明确的糖尿病与风险较低的更正常糖耐量之间的灰色地带。IGT组包括那些随后发生非胰岛素依赖型糖尿病（NIDDM）风险高但特定糖尿病并发症风险低的人群。口服葡萄糖耐量试验的变异性阻碍了将受试者分类为IGT，但即使那些仅一次显示为IGT的人患NIDDM的风险也会增加。本文讨论了遗传、胎儿期营养不足和环境生活方式因素（身体活动不足和饮食）在IGT病因和发病机制中的相对作用，所有这些因素都有影响。目前已对不同人群中IGT的患病率进行了广泛研究，成年人中的患病率在2%至25%之间。进展为NIDDM的比率也差异很大，每年从2%至14%不等。文中讨论了进展的危险因素。IGT还会增加患心血管疾病（CVD）的风险，并构成“代谢综合征”的一部分。简要回顾了胰岛素抵抗作为常见病因的作用。最后，列出了治疗IGT的可能方法，目的是延缓糖尿病和CVD的发病，这具有明显的临床重要性。
