Changes of ghrelin following oral glucose tolerance test in obese children with insulin resistance

AIM： To characterize changes in ghrelin levels in response to oral glucose tolerance test （OGTT） and to correlate changes in ghrelin levels with changes in insulin and glucose following OGTT in Chinese obese children of Tanner Ⅰ and Ⅱ stage with insulin resistance. METHODS： 22 obese children with insulin resistance state were divided into four groups according to their Tanner stage and gender： boys of Tanner Ⅰ （fir- Ⅰ ）, boys of Tanner Ⅱ（BT-Ⅱ ）, girls of Tanner Ⅰ （GT- Ⅰ ）, girls of Tanner Ⅱ （GT-Ⅱ）. Ghrelin, insulin and glucose were measured at 0, 30, 60 and 120 rain following OGTT. The control children with normal BMI were divided into control boys of Tanner Ⅰ （CBT- Ⅰ, n = 6）, control boys of Tanner Ⅱ （CBT-Ⅱ, n = 5）, control girls of Tanner Ⅰ （CGT- Ⅰ, n = 6）, control girls of Tanner Ⅱ （CGT-Ⅱ, n = 5）. Fasting serum ghrelin levels were analyzed. RESULTS： Ghrelin levels were lower in obese groups. Ghrelin levels of control group decreased in Tanner Ⅱ stage （CGT- Ⅰ vs CGT-Ⅱ t = -4.703, P = 0.001; CBT- Ⅰ vs CBT- Ⅱ t = -4.794, P = 0.001）. Basal ghrelin levels in fir-Ⅱ decreased more significantly than that in BT- Ⅰ group （t = 2.547, P = 0.029）. Ghrelin levels expressed a downward trend after OGTT among obese children. The decrease in ghrelin levels at 60 min with respect to basal values was 56.9% in BT- Ⅰ. Ghrelin concentrations at 0 min correlated directly with glucose level at 0 min in fir- Ⅰ （r = 0.898, P = 0.015）. There wasn＇t a significant correlation of ghrelin changes with glucose changes and insulin changes during OGTT in obese children with insulin resistance. CONCLUSION： In conclusion, in obese children with insulin resistance, ghrelin levels decreased with advancing pubertal stage. Ghrelin secretion suppression following OGTT was influenced by gender and pubertal stage. Baseline ghrelin levels and ghrelin suppression after OGTT did not significantly correlate with the degree of insulin resistance and insulin sensitivity.

Oral glucose tolerance test in diabetes,the old method revisited

The oral glucose tolerance test(OGTT)has been widely used both in clinics and in basic research for a long time.It is applied to diagnose impaired glucose tolerance and/or type 2 diabetes mellitus in individuals.Additionally,it has been employed in research to investigate glucose utilization and insulin sensitivity in animals.The main aim of each was quite different,and the details are also somewhat varied.However,the time or duration of the OGTT was the same,using the 2-h post-glucose load glycemia in both,following the suggestions of the American Diabetes Association.Recently,the use of 30-min or 1-h post-glucose load glycemia in clinical practice has been recommended by several studies.In this review article,we describe this new view and suggest perspectives for the OGTT.Additionally,quantification of the glucose curve in basic research is also discussed.Unlike in clinical practice,the incremental area under the curve is not suitable for use in the studies involving animals receiving repeated treatments or chronic treatment.We discuss the potential mechanisms in detail.Moreover,variations between bench and bedside in the application of the OGTT are introduced.Finally,the newly identified method for the OGTT must achieve a recommendation from the American Diabetes Association or another official unit soon.In conclusion,we summarize the recent reports regarding the OGTT and add some of our own perspectives,including machine learning and others.

Utility of oral glucose tolerance test in predicting type 2 diabetes following gestational diabetes:Towards personalized care

BACKGROUND Women with gestational diabetes mellitus(GDM)are at a seven-fold higher risk of developing type 2 diabetes(T2D)within 7-10 years after childbirth,compared with those with normoglycemic pregnancy.Although raised fasting blood glucose(FBG)levels has been said to be the main significant predictor of postpartum progression to T2D,it is difficult to predict who among the women with GDM would develop T2D.Therefore,we conducted a cross-sectional retrospective study to examine the glycemic indices that can predict postnatal T2D in Emirati Arab women with a history of GDM.AIM To assess how oral glucose tolerance test(OGTT)can identify the distinct GDM pathophysiology and predict possible distinct postnatal T2D subtypes.METHODS The glycemic status of a cohort of 4603 pregnant Emirati Arab women,who delivered in 2007 at both Latifa Women and Children Hospital and at Dubai Hospital,United Arab Emirates,was assessed retrospectively,using the International Association of Diabetes and Pregnancy Study Groups(IADPSG)criteria.Of the total,1231 women were followed up and assessed in 2016.The FBG and/or the 2-h blood glucose(2hrBG)levels after a 75-g glucose load were measured to assess the prevalence of GDM and T2D,according to the IADPSG and American Diabetes Association(ADA)criteria,respectively.The receiver operating characteristic curve for the OGTT was plotted and sensitivity,specificity,and predictive values of FBG and 2hrBG for T2D were determined.RESULTS Considering both FBG and 2hrBG levels,according to the IADPSG criteria,the prevalence of GDM in pregnant Emirati women in 2007 was 1057/4603(23%),while the prevalence of pre-pregnancy T2D among them,based on ADA criteria,was 230/4603(5%).In the subset of women(n=1231)followed up in 2016,the prevalence of GDM in 2007 was 362/1231(29.6%),while the prevalence of prepregnancy T2D was 36/1231(2.9%).Of the 362 pregnant women with GDM in 2007,96/362(26.5%)developed T2D;142/362(39.2%)developed impaired fasting glucose;29/362(8.0%)developed impaired glucose tolerance,and the remaining 95/362(26.2%)had normal glycemia in 2016.The prevalence of T2D,based on ADA criteria,stemmed from the prevalence of 36/1231(2.9%)in 2007 to 141/1231(11.5%),in 2016.The positive predictive value(PPV)for FBG suggests that if a woman tested positive for GDM in 2007,the probability of developing T2D in 2016 was approximately 24%.The opposite was observed when 2hrBG was used for diagnosis.The PPV value for 2hrBG suggests that if a woman was positive for GDM in 2007 then the probability of developing T2D in 2016 was only 3%.CONCLUSION FBG and 2hrBG could predict postpartum T2D,following antenatal GDM.However,each test reflects different pathophysiology and possible T2D subtype and could be matched with a relevant T2D prevention program.

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.

口服葡萄糖耐量试验1h血糖对糖尿病前期的诊断和鉴别价值

目的:探讨口服葡萄糖耐量试验(OGTT)1 h血糖对糖尿病前期的诊断和鉴别价值。方法:收集2019年6月至2022年6月于北京中医药大学东直门医院门诊及住院行OGTT的受试者1 206例,其中血糖正常412例,糖尿病前期358例,糖尿病436例。比较3组OGTT不同时点血糖与空腹血糖(FPG)、空腹胰岛素(FINS)、稳态模型胰岛素抵抗指数(HOMA-IR)、胰岛β细胞分泌功能指数(HOMA-β)水平;采用ROC曲线分析OGTT 1 h血糖对糖尿病前期的诊断和鉴别价值。结果:3组OGTT各时点血糖均为糖尿病组>糖尿病前期组>血糖正常组(P<0.05)。FPG、HOMA-IR糖尿病组>糖尿病前期组>血糖正常组,FINS、HOMA-β糖尿病组<糖尿病前期组<血糖正常组(P<0.05)。ROC曲线分析结果显示,OGTT 1 h血糖诊断糖尿病前期的AUC(95%CI)为0.758(0.724~0.792),以敏感度最大选取最佳切点值,该值为9.35 mmol/L,此时敏感度为0.701,特异度为0.709;OGTT 1 h血糖对糖尿病和糖尿病前期鉴别的AUC(95%CI)为0.956(0.942~0.969),以敏感度最大选取最佳切点值,该值为12.55 mmol/L,此时敏感度为0.901,特异度为0.908。结论:OGTT 1 h血糖对糖尿病前期具有一定的诊断和鉴别价值。

Subclinical abnormal glucose tolerance is a predictor of death in liver cirrhosis

AIM: To determine if subclinical abnormal glucose tolerance (SAGT) has influence on survival of non-diabetic patients with liver cirrhosis.

The Use of Glycated Albumin in the Diagnosis of Gestational Diabetes Mellitus

Gestational diabetes mellitus is the most common endocrine disorder in pregnancy and a cause of maternal and fetal morbidities and mortalities. The oral glucose tolerance test is the gold standard for diagnosing gestational diabetes mellitus. Nevertheless, the oral glucose tolerance test is time-consuming and requires patient preparation. On the contrary, Glycated albumin does not require patient preparation or administration of any substance. Most studies on glycated albumin in pregnancy were among the non-African population, and black Americans have higher glycated albumin levels than Caucasians. This study determined the use of glycated albumin in diagnosing gestational diabetes mellitus among pregnant women. The study was a prospective study of 160 pregnant women between 24 and 28 weeks of gestation at the University of Port Harcourt Teaching Hospital. The diagnosis of gestational diabetes mellitus was based on the World Health Organization 2013 criteria. The diagnostic value of glycated albumin was determined using the area under the receiver operator characteristic curve. The prevalence of gestational diabetes mellitus was 9.4% and the mean glycated albumin was 16.91% (±2.77). The area under the receiver operator characteristic curve for glycated albumin was 0.845 (95% CI 0.733 - 0.956;p = 0.0001). The optimal cut-off value of glycated albumin in the diagnosis of gestational diabetes mellitus was 18.9%. Glycated albumin was useful in the diagnosis of gestational diabetes mellitus at 24 to 28 weeks of gestation.

Responses to oral glucose challenge differ by physical activity volume and intensity: A pilot study

Background:One-hour postprandial hyperglycemia is associated with increased risk of type 2 diabetes and cardiovascular disease.Physical activity(PA)has short-term beneficial effects on post-meal glucose response.This study compared the oral glucose tolerance test results of 3 groups of people with habitually different levels of PA.Methods:Thirty-one adults without diabetes(age 25.9±6.6 years;body mass index 23.8±3.8 kg/m^2;mean±SD)were recruited and divided into 3 groups based on self-reported PA volume and intensity:low activity<30 min/day of moderate-intensity activity(n=11),moderately active≥30 min/day of moderate-intensity PA(n=10),and very active≥60 min/day of PA at high intensity(n=10).Participants completed an oral glucose tolerance test(50 g glucose)with capillary blood samples obtained at baseline,15 min,30 min,45 min,60 min,90 min,and 120 min post-ingestion.Results:There were no significant differences between groups for age or body fat percentage or glycated hemoglobin(p>0.05).The groups were significantly different in terms of baseline glucose level(p=0.003)and,marginally,for gender(p=0.053)and BMI(p=0.050).There was a statistically significant effect of PA on the 1-h postprandial glucose results(p=0.029),with differences between very active and low activity groups(p=0.008)but not between the moderately active and low activity groups(p=0.360),even when baseline glucose level and gender differences were accounted for.For incremental area under the curve there was no significant effect of activity group once gender and body fat percentage had been accounted for(p=0.401).Those in the low activity group took 15 min longer to reach peak glucose level than those in the very active group(p=0.012).Conclusion:The results suggest that high levels of PA have a beneficial effect on postprandial blood glucose profiles when compared to low and moderate levels of activity.

空腹血糖、餐后2h血糖及糖化血红蛋白对糖尿病的诊断价值

目的:探讨空腹血糖、餐后2h血糖及糖化血红蛋白(HbAlc)对糖尿病及糖调节受损的诊断价值。方法:收集2009年12月至2011年8月在郑州市第二人民医院和郑州市中心医院检测空腹血糖(FPG)、糖化血红蛋白(HbAlc)和餐后2h血糖(2h-PG)的738例临床资料完整的、HbAlc在5.4%～7.0%的就诊者入选该研究,采用ROC曲线确定HbAlc预测糖尿病及糖调节受损的诊断界点。结果:以FPG≥7.0mmol/L和(或)餐后2h-PG≥11.1mmol/L为诊断DM的金标准作ROC曲线,HbAlc=6.35%为诊断DM的最佳阈值,此切点敏感度0.698,特异度0.680,阳性似然比为2.18,阴性似然比为0.44。以FPG6.1～6.9mmol/L和(或)餐后2h-PG在7.8～11.1mmol/L作为诊断糖调节受损的金标准作ROC曲线,HbAlc=6.0%为诊断糖调节受损的最佳阈值,此切点敏感度0.646,特异度0.659,阳性似然比为1.89,阴性似然比为0.54。结论:用HbAlc诊断糖尿病敏感度中等,诊断糖调节受损敏感性不高,联合实验有助于提高糖尿病及糖调节受损的检出率。

HbA1c对糖调节受损和2型糖尿病的诊断价值

目的评估糖化血红蛋白(HbA1c)不同cut off值诊断2型糖尿病(T2DM)的效能,初步探讨美国糖尿病协会(ADA)推荐的HbA1c诊断T2DM及T2DM前期标准对中国人的适用性。方法招募接受口服葡萄糖耐量(OGTT)试验且试验前未诊治为T2DM的志愿者338例,用高效液相色谱法检测HbA1c;以WHO标准诊断糖调节受损(IGR)、糖耐量正常和T2DM;用受试者工作特征(ROC)曲线分析不同cut off值HbA1c诊断IGR和T2DM的效能。结果 HbA1c在诊断T2DM时,ROC曲线下面积(AUCROC)为0.954,最佳cut off值为6.0%,敏感性为92.5%,特异性为86.0%;当HbA1c为6.5%时,敏感性为64.8%,特异性为96.7%;当HbA1c为5.6%时,诊断T2DM阴性预测值为100.0%;HbA1c诊断IGR的AUCROC为0.653。结论 HbA1c用于IGR的诊断效能不高;HbA1c诊断T2DM最佳cut off值为6.0%,此界值诊断敏感性较FPG高,但特异性较差;ADA推荐用于T2DM诊断的cut off值6.5%主要考虑到诊断的特异性,该诊断标准适用于中国人群。

用H_2/^(13)CO_2呼吸试验检测乳糖不耐受者呼气成分的研究

为了找出能反映乳糖在肠道内分解吸收程度的良好指标 ,本研究根据乳糖负荷试验结果对筛选出的成人乳糖吸收不良者、轻度及重度乳糖不耐受者 ,研究乳糖不耐受症状与呼气成分之间的关系。在给予1 3C 乳糖 2 5g之后 ,收集 6小时的呼气样本 ,分别采用气相色谱法和气相同位素质谱法测定各时间点呼气中的H2 浓度和1 3CO2 含量并计算其累积呼出量 ;通过问卷调查摄入乳糖后 12小时内出现的不适症状及其严重程度。结果显示 :乳糖不耐受组呼气H2 浓度升高达到峰值时间较吸收不良组快 ,且峰值显著高于吸收不良组 (P <0 .0 1) ;6小时累积H2 呼出量显著高于吸收不良组 (P <0 .0 1) ;口 结肠转运时间 (OCTT)与不耐受症状评分呈负相关 (r=- 0 .70 5 ,P <0 .0 1) ;各时间点1 3CO2 的呼出量以及 6小时累积呼出量在乳糖不耐受组和吸收不良组之间无显著性差异。提示呼气中H2 浓度与不耐受症状的严重程度有相关关系 ,可以反映出乳糖在小肠内的吸收程度 ;口 -结肠转运时间与乳糖不耐受症状之间有一定相关关系 ;而呼气1 3CO2

石家庄市中老年人群HbA1c诊断2型糖尿病可行性研究

目的探讨中老年人群中糖化血红蛋白(HbA1c)诊断糖尿病(DM)的理想切点及可行性。方法采用分层随机抽样方法选择石家庄市9个社区,居住5年以上年龄≥45岁的社区居民,进行横断面流行病学调查,共调查1 845例。其中符合入选条件的1 244例行口服75 g葡萄糖耐量试验(OGTT);测定空腹血糖、服糖后2 h血糖及HbAlc。采用受试者工作特征曲线(ROC曲线)进行判断,得到以OGTT诊断DM的HbAlc值,计算最佳切点。并与OGTT标准比较,评价两者对于DM诊断率的差异。结果按照1999年WHO的DM诊断标准,研究人群中糖耐量正常(NGT)467例,空腹血糖受损(IFG)92例,糖耐量低减(IGT)198例,合并IFG+IGT 97例,新诊断糖尿病(NDDM)390例。通过绘制ROC曲线,得到HbA1c诊断DM相关的临界点为6.2%,敏感性和特异性分别为66.8%和96.1%,曲线下面积为0.859(95%CI为0.829～0.890)。与OGTT结果的符合率为75.9%。以HbA1c≥6.2%作为DM诊断切点,阳性似然比(+LR)17.13,阴性似然比(-LR)0.35,阳性预测值(+PV)74.3%,阴性预测值(-PV)77.1%。结论以HbA1c≥6.2%作为石家庄市中老年人群诊断DM的切点具有较高的敏感度与特异度。可作为临床DM筛查的切点。

慢性阻塞性肺疾病患者Th1/Th2平衡失调与糖耐量异常的关系

目的观察慢性阻塞性肺疾病（COPD）患者糖耐量状况及其与Th淋巴细胞平衡失调的关系。方法对2015年1月1日~12月31日86例稳定期COPD患者行口服糖耐量试验,测定空腹血糖（FPG）及2 h后血糖（2 h PG）,将其与同年龄健康对照组进行比较。测定反映Th1淋巴细胞功能的γ干扰素（IFN-γ）及反映Th2淋巴细胞功能的白细胞介素-4（IL-4）血清水平,将其与同年龄健康对照组进行比较。观察IFN-γ及IL-4与FPG及2 h PG的相关性。结果观察组平均FPG及2 h PG水平均高于对照组,差异有统计学意义（P〈0.05）。观察组患者血清IFN-γ水平较对照组高,IL-4水平较对照组低,差异有统计学意义（P〈0.05）。COPD患者IFN-γ与FPG及2 h PG呈正相关（r=0.4237、0.5316,P〈0.05）;IL-4与FPG及2 h PG呈负相关（r=-0.3891、-0.3625,P〈0.05）。结论 COPD患者存在糖耐量受损现象,Th1/Th2平衡失调与此种现象有关。

Type 2 diabetes after gestational diabetes: The influence of changing diagnostic criteria

A previous diagnosis of gestational diabetes(GDM)carries a lifetime risk of progression to type 2 diabetes of up to 60%.Identification of those women at higher risk of progression to diabetes allows the timely introduction of measures to delay or prevent diabetes onset.However,there is a large degree of variability in the literature with regard to the proportion of women with a history of GDM who go on to develop diabetes.Heterogeneity between cohorts with regard to diagnostic criteria used,duration of follow-up,and the characteristics of the study population limit the ability to make meaningful comparisons across studies.As the new International Association for Diabetes in Pregnancy Study Group criteria are increasingly adopted worldwide,the prevalence of GDM is set to increase by two-to three-fold.Here,we review the literature to examine the evolution of diagnostic criteria for GDM,the implications of changing criteria on the proportion of women with previous GDM progressing to diabetes,and how the use of different diagnostic criteria may influence the development of appropriate follow-up strategies.

Study on the correlation and predictive value of serum pregnancyassociated plasma protein A, triglyceride and serum 25-hydroxyvitamin D levels with gestational diabetes mellitus

BACKGROUND Gestational diabetes mellitus(GDM)is a concern due to its rapid increase in incidence in recent years.AIM To investigate the correlation and predictive value of serum pregnancyassociated plasma protein A(PAPP-A),triglyceride(TG),and 25-hydroxyvitamin D[25-(OH)D]with GDM in early pregnancy.METHODS A total of 99 patients in early pregnancy admitted to Peking University International Hospital from November 2015 to September 2017 were included,and underwent a fasting glucose test and oral glucose tolerance test screening at 24-28 wk of pregnancy.Of these cases with GDM,51 were assigned to group A and the remaining 48 cases without GDM were enrolled in group B.Serum PAPP-A,TG and 25-(OH)D in the two groups were compared and their correlation with blood sugar was analyzed.In addition,their diagnostic value in GDM was determined using receiver operating characteristic(ROC)curve analysis.RESULTS Group A had markedly lower serum PAPP-A and 25-(OH)D levels and a significantly higher serum TG level than group B,with statistical significance(P<0.05).Furthermore,Pearson analysis identified that PAPP-A and 25-(OH)D levels were negatively correlated with fasting blood glucose(FBG)levels(r=-0.605,P<0.001),(r=-0.597,P<0.001),while TG and FBG levels were positively correlated(r=0.628,P<0.001).The sensitivity,specificity,area under the curve(AUC)and optimal cut-off value of serum PAPP-A level in the diagnosis of GDM were 72.55%,82.35%,0.861 and 16.340,respectively,while the sensitivity of TG in diagnosing GDM was 86.27%,the specificity was 66.67%,the AUC was 0.813,with an optimal cut-off value of 1.796.The corresponding sensitivity,specificity,AUC and optimal cut-off value of serum 25-(OH)D were 64.71%,70.59%,0.721 and 23.140,respectively.Moreover,multivariate logistic regression analysis revealed that FBG,vascular endothelial growth factor,Flt-1,serum PAPP-A,TG,and 25-(OH)D were related risk factors leading to GDM in patients.CONCLUSION Serum PAPP-A,TG,and 25-(OH)D levels are all correlated with blood glucose changes in GDM,and are independent factors affecting the occurrence of GDM and have certain value in the diagnosis of GDM.

Comprehensive understanding of the superior performance of Sm-modified Fe_(2)O_(3)catalysts with regard to NO conversion and H_(2)O/SO_(2)resistance in the NH_(3)-SCR reaction

Sm-doped Fe_(2)O_(3)catalysts,with a homogeneous distribution of Sm in Fe_(2)O_(3)nanoparticles,were synthesized using a citric acid-assisted sol-gel method.Kinetic studies show that the reaction rate for NO_(x)reduction using the optimal catalyst(0.06 mol%doping of Sm in Fe_(2)O_(3))was nearly 11 times higher than that for pure Fe_(2)O_(3),when calculated based on specific surface area.Furthermore,the Fe_(0.94)Sm_(0.06)O_(x)catalyst maintains>83%NO_(x)conversion for 168 h at a high space velocity in the presence of SO_(2)and H_(2)O at 250℃.A substantial amount of surface-adsorbed oxygen was generated on the surface of Fe_(0.94)Sm_(0.06)O_(x),which promoted NO oxidation and the subsequent fast reaction between NO_(x)and NH_(3).The adsorption and activation of NH_(3)was also enhanced by Sm doping.In addition,Sm doping facilitated the decomposition of NH_(4)HSO_(4)on the surface of Fe_(0.94)Sm_(0.06)O_(x),resulting in its high activity and stability in the presence of SO_(2)+H_(2)O.

基于体表参数的2 h口服葡萄糖耐量试验各时间点血糖分析

目的分析2 h口服葡萄糖耐量试验(OGTT)各时间点血糖值及其与年龄、体质指数、腰围、腰臀比、腰高比的关系。方法采用简单随机抽样法选取2013年3月淮安地区某乡镇年龄>45岁人群229例,其中男50例,女179例。根据体质指数将受试者分为:正常体质量组(体质指数<24 kg/m2)和超重与肥胖组(体质指数≥24kg/m2),比较两组2 hOGTT各时间点血糖值;不同性别根据腰围值分为:腰围>参考值(男性≤85 cm,女性≤80 cm)组和腰围≤参考值组,比较不同性别两组2 hOGTT各时间点血糖值;不同性别根据腰臀比分为:腰臀比>参考值(男性≤0.9,女性≤0.85)组和腰臀比≤参考值组,比较不同性别两组2 hOGTT各时间点血糖值;根据腰高比将受试者分为:腰高比≤参考值(参考值为0.5)组和腰高比>参考值组,比较两组2 hOGTT各时间点血糖值。采用直线回归分析年龄、体质指数、腰围值、腰臀比、腰高比与2 hOGTT各时间点血糖值的相关性。结果以2 hOGTT各时间点血糖值为应变量,年龄为自变量进行直线回归分析显示,OGTT后0.5 h、1.0 h和2.0 h时血糖值与年龄均存在直线回归关系(P<0.05)。超重与肥胖组OGTT后0.5 h、1.0 h时血糖值高于正常体质量组(P<0.05);以2 hOGTT各时间点血糖值为应变量、体质指数为自变量进行直线回归分析显示,OGTT后0.5 h和1.0 h时血糖值与体质指数存在直线回归关系(P<0.05)。男性腰围>参考值组OGTT后1.0 h和2.0 h血糖值高于腰围≤参考值组(P<0.05);女性两组2 hOGTT各时间点血糖值比较,差异均无统计学意义(P>0.05);以2 hOGTT各时间点血糖值为应变量,腰围为自变量进行直线回归分析显示,OGTT后0.5 h和1.0 h血糖值与腰围存在直线回归关系(P<0.05)。男性腰臀比>参考值组与腰臀比≤参考值组2 hOGTT各时间点血糖值比较,差异均无统计学意义(P>0.05);女性腰臀比>参考值组OGTT后0.5 h和1.0 h血糖值高于腰臀比≤参考值组(P<0.05);以2 hOGTT各时间点血糖值为应变量,腰臀比为自变量进行直线回归分析显示,OGTT后1.0 h和2.0 h血糖值与腰臀比存在直线回归关系(P<0.05)。腰高比>参考值组OGTT后0.5 h和1.0 h血糖值高于腰高比≤参考值组(P<0.05);以2 hOGTT各时间点血糖值为应变量,腰高比为自变量进行直线回归分析显示,OGTT后0.5 h、1.0 h和2.0 h血糖值与腰高比存在直线回归关系(P<0.05)。结论 OGTT后0.5 h和1.0 h血糖值与OGTT后0 h和2.0 h血糖值相比,与人体多项体表参数有更好的相关性,是反映人体糖代谢异常更为敏感的指标,对糖尿病的早期诊断有着重要的意义。

Anti-hyperglycemic effects of aqueous Lenzites betulina extracts from the Philippines on the blood glucose levels of the ICR mice(Mus musculus)

Objective: To examine the anti-hyperglycemic effects of aqueous Lenzites betulina(L. betulina) extracts on normoglycemic glucose-loaded mice.Methods: Different doses of aqueous extract from L. betulina were administered to 45 ICR mice(Mus musculus) to determine whether there was an effect of L. betulina extracts on the blood glucose level of the ICR mice. Aqueous extracts of L. betulina were orally gavaged to mice using oral glucose tolerance test. A total of five groups were used to determine the effect of the fungi on blood glucose of the mice. Group A(positive control)was given 16.7 mg/kg glimepiride; Group B(negative control) was given distilled water;Group C(low dosage) was given 200 mg/kg aqueous extract; Group D(mid dosage) was given 400 mg/kg aqueous extract and Group E(high dosage) was given 800 mg/kg aqueous extract. Baseline blood glucose value was firstly acquired before induction of hyperglycemia through D-glucose, after which another check on blood glucose was made after 0.5 h. Immediately, after the acquisition of hyperglycemic blood glucose level, the individual administration of treatments were done. After that, three blood collections were done spanning 3 h with 1 h interval.Results: The low dose(200 mg/kg) and the mid dose(400 mg/kg) of L. betulina extracts were significantly different(P < 0.05) from their respective baseline values throughout the whole experiment with the latter surpassing its baseline value during the 3rd hour. On the other hand, the high dose(800 mg/kg) during the 1st hour after administration was not significantly different(P > 0.05) from its corresponding baseline value, acting faster than the positive control(glimepiride), which only became significantly different(P < 0.05) at the 2nd hour.Conclusions: Aqueous L. betulina extract is able to produce hypoglycemic effects on the mice with all doses, which are able to normalize blood glucose levels at varying times.

The Short- and Long-Term Effect of Liraglutide on the Beta Cell Function in Type 2 Diabetic Patients

Glucagon-like peptide 1 (GLP-1) is a hormone, inducing glucose-dependent stimulation of insulin secretion from beta cells. Liraglutide acts as a GLP-1 receptor agonist. To assess the effect of liraglutide on the beta cell function, we performed oral glucose tolerance tests in 7 subjects with type 2 diabetes before and after treatment of liraglutide. Moreover, we performed same study again in 4 subjects at 6 months after induction. Liraglutide significantly increased area under the Curve (AUC) of plasma insulin level after glucose loading and significantly decreased AUC of plasma glucose level, compared with before induction. HOMA-beta was significantly increased, whereas insulinogenic index was not changed. HOMA-R was not affected but Matsuda index was significantly decreased after induction of liraglutide. Disposition index was not altered significantly, but tendency of improvement was observed. Glucose tolerance tests revealed that those effects of liraglutide were continued for 6 months after induction. These results showed that treatment of liraglutide could improve insulin secretion but early phase of insulin secretion was not improved. The results suggest that liraglutide is likely to improve beta-cell function, but this effect is still inadequate by six-month treatment.