从血糖稳态看空腹血糖受损下限切点下调

The clinical significance of lowering the cut-point of impaired fasting glucose: In view of plasma glucose homeostasis

目的寻找预测2型糖尿病(T2DM)和糖耐量受损(IGT)发生的最佳空腹血糖受损(IFG)下限切点及下调的合理性。方法根据OGTT结果对北京城区2589例年龄≥20岁、既往无糖尿病史的自然人群的FPG进行ROC分析,绘制ROC曲线,并进行糖脂代谢分析。结果预测T2DM和IGT发生的最佳IFG下限切点ROC曲线下面积分别为0.949、0.692。用FPG来预测T2DM和IGT,其灵敏度及特异度均较好的点分别为5.6mmol/L和5.2mmol/L。与FPG<5.6mmol/L组比较,FPG 5.6～6.1mmol/L组胰岛素抵抗更加明显,胰岛素分泌下降,TG升高和HDL-C降低。结论将5.6mmol/L作为IFG的下限值适用于北京城区中国人群。

Objective To find the best cut-point of FPG to predict type 2 diabetes（T2DM） and impaired glucose tolerance（IGT） and to evaluate the rationality of lowering the cut-point value. Methods The ROC analysis of FPG in 2589 subjects aged 920 years without a previous history of diabetes from Dongcbeng district in Beijing was done by OGTT. The plasma glucose and lipid profile were analyzed. Results The areas under the ROC curve for predictability of FPG were 0. 949 for diabetes and 0. 692 for IGT. The cut-point of FPG with the best equilibrium between sensitivity and specificity was 5.6mmol/L for diabetes and 5.2 for IGT. Compared with subjects with FPG（5. 6mmol/L, subjects with FPG 5. 6- 6. 1mmol/L showed more insulin resistance, higher insulin response during OGTT, and reduced insulin secretion. Subjects with FPG 5. 6-6. 1mmol/L were also characterized by higher plasma triglyceride levels and reduced HDL cholesterol concentrations. Conclusions It is suitable to use 5. 6mmol/L as the low limit of IFG in Chinese people in Beijing city.