Impaired fasting glucose:Pro-diabetic,“atheroprotective”and modified by metabolic syndrome

AIM:To investigate whether impaired fasting glucose(IFG)confers cardiovascular risk.METHODS:A non-diabetic population-based sample representative of middle-aged and elderly Turks was studied at 8.5 years’follow-up for incident diabetes and coronary heart disease(CHD).Metabolic syndrome(MetS)was defined by ATP-Ⅲcriteria modifiedfor male abdominal obesity,and IFG and type 2 diabetes were identified by criteria of the American Diabetes Association.Stratification by presence of MetS was used.Outcomes were predicted providing estimates for hazard ratio(HR)obtained by use of Cox proportional hazards regression analysis in models that controlled for potential confounders.RESULTS:In 3181 adults(aged 52±11.5 years at baseline),analysis stratified by MetS,gender and IFG status distinguished normoglycemic subjects by a"hypertriglyceridemic waist"phenotype consisting of significantly higher waist circumference,fasting triglyceride and lower high-density lipoprotein-cholesterol,regardless of gender and MetS.Additionally,lipoprotein(Lp)(a)tended to be lower in(especially female)participants with MetS.Multivariable linear regression in a subset of the sample demonstrated decreased Lp(a)levels to be associated with increased fasting glucose and insulin concentrations,again particularly in women.In Cox regression analysis,compared with normoglycemia,baseline IFG adjusted for major confounders significantly predicted incident diabetes at a 3-fold HR in men and only women with MetS.Cox models for developing CHD in 339 individuals,adjusted for conventional risk factors,revealed that IFG status protected against CHD risk[HR=0.37(95%CI:0.14-0.998)]in subjects free of MetS,a protection that attenuated partly in male and fully in female participants with MetS.CONCLUSION:IFG status in non-diabetic people without MetS displays reduced future CHD risk,yet is modulated by MetS,likely due to autoimmune activation linked to serum Lp(a).

Serum Vitamin D Associated with Insulin Secretory Function in Impaired Fasting Glucose Subjects

Background: Impaired fasting glucose (IFG) is a prediabetic condition and is a high-risk state for developing diabetes and associated complications. The aim of this study was to explore the association of vitamin D with insulin secretory function among the IFG subjects. Materials and Methods: This was a prospective cross-sectional study conducted in the Department of Biochemistry and Cell Biology, Bangladesh University of Health Sciences (BUHS), Dhaka, Bangladesh;from June 2016 to May 2017, on forty-six (46) IFG subjects. Serum blood glucose was measured by glucose-oxidase method, Fasting serum lipid profile (Total cholesterol, TG and HDL-c);liver enzyme like alanine aminotransferase (ALT) was measured by enzymatic-colorimetric method;Serum creatinine was measured by colorimetric kinetic method;Serum Insulin and vitamin D [25(OH)D] were measured by ELISA method;insulin secretory capacity (HOMA%B) and insulin sensitivity (HOMA%S) were calculated by Homeostasis Model Assessment (HOMA) using HOMA-CIGMA software. Results: Among 46 IFG subjects, 22 (47.8%) were male and rest 24 (52.2%) were female and their mean age was 40 (±8) years. Mean fasting serum glucose level of the study subjects was 6.33 (±0.23) mmol/l and mean postprandial serum glucose level was 7.23 (±0.41) mmol/l. Mean serum vitamin D level of the study subjects was 26.54 (±8.83) ng/ml. Mean HOMA%S, HOMA%B and HOMA%IR of the total study subjects were 48.34 (±16.70), 102.16 (±23.13) and 2.28 (±0.70) respectively. Insulin secretory capacity (HOMA%B) was significantly higher (p = 0.047) in the subjects having higher vitamin D [25(OH)D level ≥ 20 ng/ml] compared to the subjects having lower vitamin D [25(OH)D levels Conclusion: High prevalence of hypovitaminosis D exists among IFG subjects. Vitamin D is associated with insulin secretory function in IFG subjects. Population based prospective studies using larger sample size should be done to confirm the results.

Impairment of extra-high frequency auditory thresholds in subjects with elevated levels of fasting blood glucose

This study was performed to assess whether there is an association between elevated Fasting Blood Glucose(FBG) and hearing impairment in Bangladeshi population. A total of 142 subjects(72 with elevated FBG; 70 control) were included in the study. The mean auditory thresholds of the control subjects at 1,4,8 and 12 kHz frequencies were 6.35 ± 0.35,10.07 ± 0.91,27.57 ± 1.82, 51.28 ± 3.01 dB SPL(decibel sound pressure level), respectively and that of the subjects with elevated FBG were 8.33 ± 0.66,14.37 ± 1.14, 38.96 土 2.23, and 71.11 ± 2.96 dB.respectively. The auditory thresholds of the subjects with elevated FBG were significantly(p < 0.05) higher than the control subjects at all the above frequencies, although hearing impairment was most evidently observed at an extra-high(12 kHz) frequency. Subjects with a long duration of diabetes(>10 years) showed significantly(p < 0.05) higher level of auditory thresholds at 8 and 12 kHz, but not at 1 and 4 kHz frequencies,compared to subjects with shorter duration of diabetes(≤10 years). In addition, based on the data of odds ratio, more acute impairment of hearing at the extra-high frequency was observed in diabetic subjects of both older(>40 years) and younger(<40 years) age groups compared to the respective controls. The binary logistic regression analysis showed a 5.79-fold increase in the odds of extra-high frequency hearing impairment in diabetic subjects after adjustment for age, gender and BMI. This study provides conclusive evidence that auditory threshold at an extra-high frequency could be a sensitive marker for hearing impairment in diabetic subjects.

Retinal microcirculation changes in prediabetic patients with shortterm increased blood glucose using optical coherence tomography angiography

BACKGROUND Retinal microcirculation alterations are early indicators of diabetic microvascular complications.Optical coherence tomography angiography(OCTA)is a noninvasive method to assess these changes.This study analyzes changes in retinal microcirculation in prediabetic patients during short-term increases in blood glucose using OCTA.AIM To investigate the changes in retinal microcirculation in prediabetic patients experiencing short-term increases in blood glucose levels using OCTA.METHODS Fifty volunteers were divided into three groups:Group 1[impaired fasting glucose(IFG)or impaired glucose tolerance(IGT)],Group 2(both IFG and IGT),and a control group.Retinal microcirculation parameters,including vessel density(VD),perfusion density(PD),and foveal avascular zone(FAZ)metrics,were measured using OCTA.Correlations between these parameters and blood glucose levels were analyzed in both the fasting and postprandial states.RESULTS One hour after glucose intake,the central VD(P=0.023),central PD(P=0.026),and parafoveal PD(P<0.001)were significantly greater in the control group than in the fasting group.In Group 1,parafoveal PD(P<0.001)and FAZ circularity(P=0.023)also increased one hour after glucose intake.However,no significant changes were observed in the retinal microcirculation parameters of Group 2 before or after glucose intake(P>0.05).Compared with the control group,Group 1 had a larger FAZ area(P=0.032)and perimeter(P=0.018),whereas Group 2 had no significant differences in retinal microcirculation parameters compared with the control group(P>0.05).Compared with Group 1,Group 2 had greater central VD(P=0.013)and PD(P=0.008)and a smaller FAZ area(P=0.012)and perimeter(P=0.010).One hour after glucose intake,Group 1 had a larger FAZ area(P=0.044)and perimeter(P=0.038)than did the control group,whereas Group 2 showed no significant differences in retinal microcirculation parameters compared with the control group(P>0.05).Group 2 had greater central VD(P=0.042)and PD(P=0.022)and a smaller FAZ area(P=0.015)and perimeter(P=0.016)than Group 1.At fasting,central PD was significantly positively correlated with blood glucose levels(P=0.044),whereas no significant correlations were found between blood glucose levels and OCTA parameters one hour after glucose intake.CONCLUSION A short-term increase in blood glucose has a more pronounced effect on retinal microcirculation in prediabetic patients with either IFG or IGT.

Repetitiveness of the oral glucose tolerance test in children and adolescents

BACKGROUND Data regarding the most suitable diagnostic method for the diagnosis of glucose impairment in asymptomatic children and adolescents are inconclusive.Furthermore,limited data are available on the reproducibility of the oral glucose tolerance test(OGTT)in children and adolescents who are obese(OB).AIM To investigate the usefulness of the OGTT as a screening method for glucose dysregulation in children and adolescents.METHODS Eighty-one children and adolescents,41 females,either overweight(OW),OB or normal weight(NW)but with a strong positive family history of type 2 diabetes mellitus(T2DM),were enrolled in the present observational study from the Outpatient Clinic of Paediatric Endocrinology of the University Hospital of Patras in Greece.One or two 3-h OGTTs were performed and glucose,insulin and Cpeptide concentrations were measured at several time points(t=0 min,t=15 min,t=30 min,t=60 min,t=90 min,t=120 min,t=180 min).RESULTS Good repetitiveness was observed in the OGTT response with regard to T2DM,while low repetitiveness was noted in the OGTT response with regard to impaired glucose tolerance(IGT)and no repetitiveness with regard to impaired fasting glucose(IFG).In addition,no concordance was observed between IFG and IGT.During the 1st and 2nd OGTTs,no significant difference was found in the glucose concentrations between NW,OW and OB patients,whereas insulin and C-peptide concentrations were higher in OW and OB compared to NW patients at several time points during the OGTTs.Also,OW and OB patients showed a worsening insulin and C-peptide response during the 2nd OGTT as compared to the 1st OGTT.CONCLUSION In mild or moderate disorders of glucose metabolism,such as IFG and IGT,a diagnosis may not be reached using only one OGTT,and a second test or additional investigations may be needed.When glucose metabolism is profoundly impaired,as in T2DM,one OGTT is probably more reliable and adequate for establishing the diagnosis.Excessive weight and/or a positive family history of T2DM possibly affect the insulin and C-peptide response in the OGTT from a young age.

The influence of OCT1 gene polymorphisms on the metformin response in Uygur patients with glucose metabolism disorder

Objective To determine the effects of genetic variation in the organic cation transporter 1(OCT1)on the short-term responses of the antidiabetic drug,metformin.Method A total of 22 patients recruited with type 2 diabetes or IFG were treated with metformin(2 000 mg/day)for 1 week.The patients were screened from Second Jikun hospital and Kashidonglu community medicine service,Urumqi,China and their surrounding districts.To examine the effects of metformin on plasma glucose,total cholesterol,low-density lipoprotein-cholesterol,high-density lipoprotein-cholesterol and triglyceride in relation with R61C,G465R and 420 del variants of OCT1(gene encoding organic cation transporter 1,mainly locating in liver,which is metformin's major target)in subjects.In all,R61C,G465R and 420del of OCT1 gene were examined using DNA extracted from whole blood and PCR-RFLP.Data concerning with gene and metformin treatment were handled by t-test.Result After metformin treatment,there were increases both in FPG and LDL(P=0.011and P=0.013 respectively).To divide all participants into mutant and wild groups,according to the polymorphisms of R61C,G465R and 420 del respectively,as well as carriers with one of the mutant genotypes at least and carriers with none of the mutant sites.Analysis was made to compared FPG,Chol,TG,and LDL and HDL between carriers of wild genotypes and carriers of other genotypes showed no statistic significance both before the metformin treatment and after the treatment.The same is the case with changes of FPG,Chol,TG,and LDL and HDL of wild genotype carriers and variant genotype carriers,except of LDL changes(P=0.05)in patients grouped by G465R polymorphisms and TG changes(P=0.03)in subjects differed by 420del genotypes.Conclusion In this study,it is suggested that OCT1 gene polymorphisms have little contribution to the clinical efficacy of blood glucose control by metformin among Uygur people with type 2 diabetes or IFG,but it may have possible relationship with the clinical efficacy on fat metabolism by metformin.

糖调节受损与ST段抬高型心肌梗死患者经皮冠状动脉介入治疗术中慢血流或无复流的关系

目的 探讨糖调节受损(IGR)与ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入治疗(PCI)术中慢血流或无复流(SF/NRF)的关系。方法 回顾性收集本院2021年10月—2022年10月收治的80例有SF/NRF的STEMI患者及84例无SF/NRF的STEMI患者的临床资料,包括空腹血糖、总胆固醇(TC)、甘油三酯(TG)、心肌肌钙蛋白Ⅰ(cTnⅠ)、纤维蛋白原、左心室射血分数(LVEF)、D-二聚体、尿酸、同型半胱氨酸、中性粒细胞绝对值与淋巴细胞绝对值比值(NLR)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)以及餐后2 h血糖水平。采用Logistic回归模型分析影响STEMI患者PCI术中SF/NRF发生的影响因素;采用受试者工作特征(ROC)曲线分析空腹血糖、餐后2 h血糖水平对STEMI患者PCI术中SF/NRF的诊断价值。结果 与非SF/NRF组相比,SF/NRF组cTnⅠ、纤维蛋白原、HDL-C水平升高,收缩压(SBP)、舒张压(DBP)、NLR水平降低,差异有统计学意义(P<0.05)。与非SF/NRF组相比,SF/NRF组支架直径、支架长度、胸痛至导管室时间更长,差异有统计学意义(P<0.05)。SF/NRF组空腹血糖、餐后2 h血糖水平高于非SF/NRF组,差异有统计学意义(P<0.05)。Logistic回归分析显示,空腹血糖、餐后2 h血糖水平是STEMI患者PCI术中SF/NRF发生的影响因素,且二者联合诊断STEMI患者PCI术中SF/NRF的曲线下面积(AUC)高于空腹血糖、餐后2 h血糖水平单独诊断的AUC(Z=3.272、4.369,P均<0.001)。结论 IGR与STEMI患者PCI术中SF/NRF有关,空腹血糖、餐后2 h血糖水平是STEMI患者SF/NRF发生的影响因素。

单纯IGT和单纯IFG个体高敏C反应蛋白水平的差异及相关因素分析

目的比较正常空腹血糖/正常糖耐量(NFG/NGT)、空腹血糖受损(IFG)、糖耐量减低(IGT)及IFG/IGT个体的血清高敏C反应蛋白(hsC-RP)水平的差异,并对其相关因素进行分析。方法将443名39～65岁非糖尿病(DM)个体根据OGTT分为以下4组:NFG/NGT、单纯IFG、单纯IGT和IFG/IGT组。比较各组间血清hsC-RP的差异,并对与之相关的变量进行统计学分析。结果IGT组比IFG组hsC-RP水平明显升高(P<0.05),IFG组与NFG/NGT组以及IGT组与IFG/IGT组间的hsC-RP水平没有明显统计学差异(P>0.05)。多元逐步回归分析显示,BMI和胰岛素抵抗指数是hsC-RP的独立预告因子。结论IGT比IFG个体的血清hsC-RP水平明显升高,hsC-RP与胰岛素抵抗和代谢综合征的多种组分相关。

Pros and cons of live kidney donation in prediabetics: A critical review and way forward

There is shortage of organs,including kidneys,worldwide.Along with deceased kidney transplantation,there is a significant rise in live kidney donation.The prevalence of prediabetes(PD),including impaired fasting glucose and impaired glucose tolerance,is on the rise across the globe.Transplant teams frequently come across prediabetic kidney donors for evaluation.Prediabetics are at risk of diabetes,chronic kidney disease,cardiovascular events,stroke,neuropathy,retinopathy,dementia,depression and nonalcoholic liver disease along with increased risk of all-cause mortality.Unfortunately,most of the studies done in prediabetic kidney donors are retrospective in nature and have a short follow up period.There is lack of prospective long-term studies to know about the real risk of complications after donation.Furthermore,there are variations in recommendations from various guidelines across the globe for donations in prediabetics,leading to more confusion among clinicians.This increases the responsibility of transplant teams to take appropriate decisions in the best interest of both donors and recipients.This review focuses on pathophysiological changes of PD in kidneys,potential complications of PD,other risk factors for development of type 2 diabetes,a review of guidelines for kidney donation,the potential role of diabetes risk score and calculator in kidney donors and the way forward for the evaluation and selection of prediabetic kidney donors.

南京机关背景人群新旧IFG诊断标准与IGT诊断一致性分析

目的探讨ADA空腹血糖受损(IFG)诊断标准下调对IFG患病率的影响,比较诊断切点调整前后IFG与糖耐量异常(IGT)诊断的一致性。方法南京地区机关背景1163例无糖尿病史成人,均行75g口服葡萄糖耐量试验。计算IFG、IGT的患病率,采用κ检验评价不同诊断标准之间的一致性。以IGT为参照,对不同空腹血糖(FPG)值建立受试者工作特征曲线(ROC曲线),寻找FPB的理想临界值。结果下调诊断标准,IFG患病率由3.10%上升至8.94%,接近IGT患病率9.20%;诊断一致性检验量κ由0.230上升为0.296。ROC曲线分析提示以IGT为参照,最匹配的FPB切点为5.1mmol/L。结论①下调IFG诊断切点至5.6mmol/L,可增加IFG与IGT患病率的一致性;②IFG诊断切点下调适用于本研究人群;③IFG与IGT的重叠有限。仅以FPG不能替代餐后2-h血糖(2hPG)。

疗养军事飞行人员糖代谢现状调查分析

目的 调查疗养军事飞行人员的血糖代谢现状,分析其糖代谢异常的发病特点,为飞行人员的糖尿病(diabetes mellitus,DM)航卫保障提供科学依据。方法 随机抽取2021-01/2023-09月于某中心疗养的军事飞行人员共2591例,行口服葡萄糖耐量试验,测定其空腹血糖(fasting plasma glucose,FPG)、餐后2 h血葡萄糖(2 h postprandial blood glucose,2 hPG)和糖化血红蛋白(glycosylated hemoglobin,HbA_(1)c),统计DM、糖尿病前期(pre-diabetes mellitus,PDM)的患病率,比较不同年龄段(年龄<30岁、30岁≤年龄<40岁、40岁≤年龄<50岁、年龄≥50岁)、不同飞行时间(飞行时间<1000 h、1000 h≤飞行时间<3000 h、3000≤飞行时间<5000 h、飞行时间≥5000 h)、不同勤务类别(空勤、战勤)、不同机种(歼击机、轰炸机、直升机、运输机、其他)飞行人员血糖代谢情况。结果 2591例军事飞行人员中,诊断为PDM 286例(11.04%),诊断为DM 49例(1.89%),血糖正常2256例(87.07%)。在286例PDM患者中,空腹血糖受损(impaired fasting glucose,IFG)、糖耐量减低(impaired glucose tolerance,IGT)、IFG合并IGT及单纯5.7%≤HbA_(1C)≤6.4%者的检出率分别为1.93%、2.82%、2.01%、4.28%。军事飞行人员DM或PDM患病率及FPG、2 hPG、HbA_(1C)水平随年龄增大而增加(P均<0.01),随飞行时间增长而增加(P均<0.01),不同勤务类别、不同机种DM或PDM患病率及FPG、2 hPG、HbA_(1C)水平差异均无统计学意义(P均>0.05)。结论 军事飞行人员血糖代谢问题突出,潜在DM患病风险高,飞行人员DM或PDM患病率及FPG、2hPG、HbA_(1C)水平随年龄及飞行时间增加而增加,而与勤务类别和机种关系不大,应加强飞行人员DM防控措施。

土木同调法防治IFG的临床观察

目的立足《内经》"五行圆运动"学说,观察土木同调法防治空腹血糖受损(IFG)的临床疗效。方法选取糖尿病前期属IFG的患者共40例,随机分为治疗组20例,对照组20例。2组均实施生活方式干预,在此基础上,治疗组加予中成药附子理中丸联合逍遥丸口服,治疗3个月。期间观察各组患者治疗前后空腹血糖(FBG)、餐后2h血糖(2h PBG)、糖化血红蛋白(Hb A1c)、体重指数(BMI)、血脂指标(TG、TC、HDL-C、LDL-C)。结果除2h PBG、HDL-C外,各指标在2组治疗前后均得到不同程度改善;尤其在降低FBG、BMI、TG、LDL-C方面,治疗组较对照组具有显著优势,且中药治疗安全性良好。结论糖尿病前期的关键病机为土木不调,基于土木同调法能有效防治IFG,为糖尿病前期提供安全有效的治疗选择。

基于China-PAR评估空腹血糖调节受损人群10年动脉粥样硬化性心血管疾病风险

目的基于中国动脉粥样硬化性心血管病风险预测研究(China-PAR)模型,探索空腹葡萄糖调节受损(IFG)与10年动脉粥样硬化性心血管疾病风险(ASCVD)的相关性。方法收集2016年1月至2020年12月在该院进行健康体检的人群,随机选取100例IFG人群及100例空腹血糖正常人群作为对照组。IFG根据美国ADA指南定义为(5.6 mmol/L≤FBG<7.0 mmol/L)。基于China-PAR进行ASCVD风险预测。结果与空腹血糖健康人群相比,IFG组的体质量指数(BMI)、腰围、腰臀比、血压、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、胰岛素等均升高(P<0.05)。基于China-par模型评估,IFG组的10年ASCVD风险显著高于对照组(P=0.011),且两组在低危及中高危的构成比差异有统计学意义(χ^(2)=4.978,P=0.026)。Spearman相关分析显示,10年ASCVD风险与年龄、BMI、腰围、腰臀比、收缩压、舒张压、FBG、HbA1C、TG、CRP呈正相关(P<0.05),与HDL-C呈负相关(P<0.05)。结论基于China-PAR评估模型,IFG与10年ASCVD风险升高密切相关。

北京市西城区孕前体检女性空腹血糖受损相关因素研究

目的分析孕前健康体检女性人群空腹血糖受损的影响因素。方法选择2017年1月至2020年12月于北京市西城区妇幼保健院进行孕前体检计划妊娠的育龄女性作为研究对象,通过问卷调查、体格检查、血常规和血清学检验收集资料。使用SPSS 23.0软件,采用秩和检验、χ^(2)检验以及Logistic回归分析方法,分析孕前体检女性人群空腹血糖受损的相关影响因素。结果共纳入2102名育龄女性,2017~2020年标化空腹血糖受损检出率分别为0.81%、0.47%、0.35%以及0.24%(P_(χ^(2))=0.118,Ptrend<0.05)。多因素Logistic分析结果显示,26~30岁及31~35岁组空腹血糖受损检出率均是36岁及以上人群组的0.226倍;食用生肉人群空腹血糖受损发生的风险是不食用生肉人群的4.879倍(95%CI:1.438~16.560);白细胞计数、红细胞计数和转氨酶每增加1个单位,空腹血糖受损发生风险分别升高0.514倍(95%CI:1.271~1.804),1.956倍(95%CI:1.042~-8.390)和0.026倍(95%CI:1.010~1.043)。结论孕前体检女性人群的年龄升高、食用生肉、白细胞计数增加、转氨酶升高、红细胞计数增加是空腹血糖受损的发生危险因素。

IFG与IGT患者血脂和冠状动脉病变的差异研究

目的分析空腹血糖受损(IFG)、糖耐量受损(IGT)患者血脂代谢异常和冠状动脉Gensini评分的差异。方法选择行冠状动脉造影检查的患者87例,根据WHO标准分为IFG组21例,IGT组30例,糖尿病(DM)组36例,记录检测患者年龄、性别、体重指数(BMI)、尿酸(UA)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)、总胆固醇(TC)、冠状动脉Gensini评分。结果 IFG组Gensini评分低于DM组,差异有统计学意义(P<0.05);IGT组Gensini评分低于DM组,差异无统计学意义。DM组TC高于IGT组、IFG组,差异有统计学意义(P<0.05);IGT组TC低于IFG组,但差异无统计学意义。3组TG、HDL-C、LDL-C、UA差异无统计学意义。结论 IGT对冠状动脉的影响比IFG更大,IGT和IFG均存在血脂代谢异常,应早期进行干预。

IFG患者的糖尿病和IGT的患病率

目的 :探讨空腹糖耐量异常 (IFG)患者的归属 ,其糖尿病和糖耐量异常的患病率。方法 :对 5 2例IFG病人进行口服葡萄糖耐量试验。结果 :①糖尿病组 :2 5例 ,占 48.1% ;②糖耐量减低组 (IGT) :2 2例 ,占 42 .3% ;③正常组 :5例 ,占 9.6 %。结果显示 :IFG患者仍有较高的糖尿病发病率。结论 :IFG患者应作口服葡萄糖耐量试验(OGTT)检查 ,不能单纯以空腹血糖诊断糖尿病。

Gender differences in the relationship between plasma lipids and fasting plasma glucose in non-diabetic urban Chinese popula- tion： a cross-section study

The association between dyslipidemia and elevated fasting glucose in type 2 diabetes is well known. In non-diabetes, whether this association still exists, and whether dyslipidemia is an independent risk factor for high fasting plasma glucose （FPG） levels are not clear. This cross-sectional study recruited 3460 non-diabetic Chinese subjects （1027 men, and 2433 women, aged 35-75 years old） who participated in a health survey. Men and women were classified into tertiles by levels of plasma lipids respectively. In women, the prevalence of impaired fasting glucose （IFG） was decreased with increased HDL-C. A stepwise increase in HDL-C was associated with decreasing FPG levels （lowest tertiles, FPG： 5.376 ± 0.018; middle tertiles, 5.324± 0.018; highest tertiles, 5.276±0.018mmol/L; P = 0.001）. Reversely, FPG levels increased from lowest tertiles to highest tertiles of LDL-C, TC, and TG. we found that women in the first tertile with lower HDL-C level had a 1.75-fold increase in risk of IFG compared with non-diabetic women in the third tertile with higher HDL-C level （OR： 1.75; 95% CI： 1.20-2.56）. In men, no significant association was found. We took age, BMI, waist/hip ratio, education, smoking, alcohol drinking, and physical exercise as adjusted variables. In Chinese non-diabetic women, dyslipidemia is independently associated with high levels of FPG; TG, HDL-C, and LDL-C are predictors of IFG independent of BMI and waist/hip ratio.

T2DM、IGT、IFG老年患者血管内皮功能与血小板膜糖蛋白关系的研究

目的研究不同血糖状态下血小板活化程度与血管内皮功能变化的关系。方法分别选取老年IFG、IGT、T2DM患者和正常对照组各20例,采集空腹静脉血测定FPG、TG、TC、HDL-C、LDL-C、HbA1c等,同时送检血小板膜糖蛋白CD61和CD62P。采用高分辨率血管外彩超测定肱动脉反应性充血舒张度(FMD)和含服硝酸甘油后内径变化度(NTG)。结果①T2DM组、IGT组、IFG组的FMD较NC组显著下降(P<0.05),而T2DM组的NTG与IGT组、IFG、NC组相比显著下降(P<0.05)。②T2DM组、IGT组、IFG组的CD61和CD62P较NC组明显升高(P<0.05)。结论内皮功能损害和血小板活化在糖尿病前期就已经存在了,两者互相促进,在糖调节受损和糖尿病患者早期血管病变的发生发展中共同发挥着关键的作用。

儿童肥胖症糖代谢状态的再探讨

目的分析肥胖儿童的糖代谢状态。方法266例肥胖儿童为研究对象,检查空腹血糖(FPG)、空腹胰岛素(FINS)、糖化血红蛋白(HbA1c)、口服葡萄糖耐量试验(OGTT)和胰岛素释放试验(IRT),计算胰岛素抵抗指数(HOMA-IR)、量化胰岛素敏感指数(QUICKI)和胰岛素峰值/空腹胰岛素(I p/I 0)。200例非肥胖的健康儿童为对照组,比较两组糖代谢指标。比较不同肥胖程度儿童的糖代谢指标、胰岛素抵抗(IR)发生率。分析肥胖儿童的糖尿病前期风险因素,体质指数(BMI)相关性分析。结果肥胖儿童糖尿病前期及2型糖尿病比例达18.0%(48/266)。肥胖组FINS、HOMA-IR、HbA1c大于对照组,QUICKI低于对照组(P<0.05);两组FPG差异无统计学意义(P=0.423)。重度肥胖组FINS、HOMA-IR大于轻中度肥胖组,I p/I 0小于轻中度肥胖组(P<0.05),FPG、QUICKI、HbA1c、2小时血糖(2hPG)差异无统计学意义。轻中度肥胖、重度肥胖组IR发生率差异无统计学意义(P=0.163)。Logistic回归提示BMI、黑棘皮病等对糖尿病前期的影响差异无统计学意义。相关性分析提示,BMI与FPG无相关性(P=0.160),与FINS、HOMA-IR、2hPG、HbA1c呈正相关(P<0.05),与QUICKI、I p/I 0呈负相关(P<0.05)。结论近20%肥胖儿童已有糖代谢异常。肥胖儿童普遍存在胰岛素抵抗,其发生率不受肥胖程度的影响。

北京市大兴区成人空腹血糖受损现状调查

目的调查北京市大兴区成人空腹血糖受损流行病学现状,在否认糖尿病病史人群中了解其空腹血糖异常的比例及其与血脂代谢的关系,为这部分人群的血糖体检筛查,以及预防发生糖尿病及心脑血管疾病提供参考.方法2018年1-10月在中国中医科学院广安门医院体检的北京市大兴区居民共805人,采用问卷调查了解糖尿病知晓率,并检测血糖、血脂等实验室项目.结果在698名否认糖尿病病史的受访者中,空腹血糖受损(IFG)103例(14.8%),空腹血糖(FBG)升高者130例(18.6%),与FBG正常组(541例,77.5%)相比,IFG组以及FBG升高组的三酰甘油(TG)、残粒脂蛋白(RLP)、小而密低密度脂蛋白(sdLDL-C)均显著升高(P<0.05),高密度脂蛋白(HDL-C)则显著降低(P<0.05).在年龄>60岁人群中,有糖尿病病史组的空腹血糖正常率显著高于否认有糖尿病病史组(80.8%vs.64.4%,P=0.026).结论在北京市大兴区受访人群中,空腹血糖受损等血糖代谢异常的比例依然较高,且在否认糖尿病病史受访者中更为明显,并容易伴随血脂代谢异常.对血糖代谢异常的知晓、健康教育并控制高血脂等危险因素,对他们可能是干预和治疗的关键.