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.

孕中期GDM患者血清Afamin和SFRP5水平及临床价值分析

目的分析孕中期妊娠期糖尿病(GDM)患者血清α清蛋白(Afamin)和分泌型卷曲相关蛋白5(SFRP5)水平及临床价值。方法选取2019年8月至2021年8月河北省秦皇岛市海港医院120例定期产检并分娩的孕妇为研究对象,其中GDM孕妇50例为GDM组,非GDM孕妇70例为对照组。采用酶联免疫吸附试验(ELISA)检测两组血清Afamin和SFRP5水平;采用口服葡萄糖耐量试验(OGTT)检测OGTT 1 h血糖(1 h PG)、OGTT 2 h血糖(2 h PG);检测空腹血糖(FPG)、糖化血红蛋白(HbA1c)及空腹胰岛素(FINS)水平;分析Afamin、SFRP5与糖代谢指标之间的相关性;采用受试者工作特征(ROC)曲线评估Afamin、SFRP5单独及联合检测对GDM的诊断价值;分析不同Afamin、SFRP5水平孕妇不良妊娠结局发生情况。结果GDM组FPG、1 h PG、2 h PG、HbA1c和FINS水平明显高于对照组,差异有统计学意义(P<0.05);GDM组Afamin水平明显高于对照组,SFRP5水平明显低于对照组,差异有统计学意义(P<0.05);Afamin水平与FPG、1 h PG、2 h PG、HbA1c和FINS水平呈正相关(P<0.05);SFRP5水平与FPG、1 h PG、2 h PG、HbA1c和FINS水平呈负相关(P<0.05);ROC曲线分析结果显示,血清Afamin和SFRP5单独及联合检测诊断GDM的曲线下面积(AUC)分别为0.747、0.642、0.872,且联合检测的灵敏度为89.3%,特异度为77.9%,联合检测的AUC明显大于单独检测的AUC,差异有统计学意义(P<0.05)。以所有孕妇的Afamin、SFRP5水平均值为界,分为高Afamin组、低Afamin组,以及高SFRP5组、低SFRP5组,高Afamin组母婴不良妊娠结局发生率高于低Af amin组,低SFRP5组母婴不良妊娠结局发生率高于高SFRP5组,差异有统计学意义(P<0.05)。结论Afamin和SFRP5作为诊断GDM的生物标志物具有良好的效能,在临床上可以预测GDM的发展趋势和不良妊娠结局的风险。

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.

75 g OGTT不同时间点血糖指标与妊娠期糖尿病产妇妊娠结局的关系分析

目的:研究75 g口服葡萄糖耐量试验(OGTT)不同时间点血糖指标与妊娠期糖尿病(GDM)产妇妊娠结局的关系。方法:403例GDM产妇,其75 g OGTT结果中仅1项血糖升高为A组(空腹血糖升高为A1组,1小时血糖升高为A2组,2小时血糖升高为A3组),2项血糖升高为B组(空腹及1小时血糖升高为B1组,空腹及2小时血糖升高为B2组,1小时及2小时血糖升高为B3组),3项血糖升高为C组。回顾性分析孕妇一般资料和妊娠结局。结果:A、B、C 3组孕妇甲状腺功能减退、妊娠期高血压疾病、剖宫产发生率及新生儿体质量指数(BMI)、胸围、巨大儿、早产、转入新生儿科发生率比较差异有统计学意义(P<0.05),C组母儿不良结局发生率高于A、B组;A2组新生儿BMI、胸围、胎儿窘迫及剖宫产发生率高于A1和A3组(P<0.05);B3组巨大儿及剖宫产发生率低于B1与B2组。结论:75 g OGTT 3项时间点血糖均升高的GDM产妇母儿不良结局增加;空腹及任何1项服糖后血糖升高时,产妇剖宫产及新生儿巨大儿发生率增加;1小时血糖升高和新生儿BMI可能有关。

妊娠期糖尿病75gOGTT不同时点血糖异常与妊娠结局的相关性分析

目的探讨妊娠期糖尿病孕妇不同血糖指标异常与妊娠结局的关系。方法选择2016年1至12月于昆山市第一人民医院定期产检并分娩的937例妊娠期糖尿病孕妇,孕24~28周均直接行75g葡萄糖耐量试验(75g OGTT),单纯空腹血糖异常为A组,餐后1h或2h血糖异常而空腹血糖正常为B组,空腹及餐后1h或2h血糖异常为C组,分析三组孕妇妊娠结局及胰岛素使用率的差异。为分析不同指标血糖异常与新生儿出生体重的相关性,将单纯空腹血糖异常为空腹血糖组,单纯OGTT1h异常为OGTT1h组,单纯OGTT2h异常为OGTT2h组,分别将三组的空腹血糖、OGTT1h血糖、OGTT2h血糖与相应的新生儿出生体重进行相关性分析。结果在937例GDM孕妇中,A组323例(34.47%)、B组436例(46.53%)、C组178例(19.00%)。A、B、C三组在早产、巨大儿及产后出血的比较中具有显著差异(χ~2值分别为6.72、12.00、6.29,均P<0.05);两两比较,C组的早产、产后出血率均明显高于A组和B组(χ~2值分别为4.37、4.61、5.78、4.89,均P<0.05),A组和C组的巨大儿发生率均显著高于B组(χ~2值分别为4.75和11.86,均P<0.05),而A组和C组的巨大儿发生率无明显差异(χ~2=1.99,P>0.05),A组和B组在早产及产后出血方面的比较无明显差异(χ~2值分别为0.03、0.00,均P>0.05)。三组在胎膜早破、妊娠合并甲状腺机能减退、妊娠高血压疾病方面无明显差异(χ~2值分别为0.94、0.39、0.56,均P>0.05)。三组胰岛素使用率比较,C组明显高于GDM A组,且A组显著高于B组,差异均有统计学意义(χ~2值分别为15.81、5.44,均P<0.05);在相关性比较中发现,在诊断的GDM孕妇中,OGTT中的空腹血糖与新生儿的出生体重呈正相关,差异有统计学意义(r=0.12,P<0.05);而OGTT1h及OGTT2h血糖与新生儿出生体重无明显相关(r值分别为0.08,0.01,均P>0.05)。结论 GDM孕妇空腹血糖异常合并l项或两项不同时间点血糖异常,其不良妊娠结局发生率明显增加,OGTT空腹血糖值对于妊娠期糖尿病检测及新生儿体重的预测具有重要意义。临床上应根据OGTT异常情况进行分层管理。

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.

IADPSG标准下75g和100g OGTT诊断GDM的价值比较

目的比较IADPSG标准下75g和100g OGTT诊断GDM的价值。方法选取2017年8月1日至2019年8月1日在铜川市人民医院进行GDM筛查的1069例孕妇作为研究对象,其中573例进行75g OGTT(75g组),496例进行100g OGTT(100g组)。比较两组诊断GDM的临床价值。结果两组孕妇的空腹葡萄糖水平无显著差异(P>0.05)。75g组服糖1、2 h的葡萄糖水平低于100g组(P<0.05)。75g组采用IADPSG诊断阈值而100g组采用ADA诊断阈值时,75g组GDM诊断率高于100g组(P<0.05);两组均采用IADPSG诊断阈值时,GDM诊断率无显著差异(P>0.05)。采用IADPSG诊断标准时,两组的空腹、服糖后1 h阳性率无显著差异(P>0.05);75g组服糖后2 h阳性率低于100g组(P<0.05)。两组均采用IADPSG诊断阈值时,通过1个点阳性和2个点阳性诊断为GDM的占比无显著差异(P>0.05);75 g组通过3个点阳性诊断为GDM的占比低于100 g组,差异具有统计学意义(P<0.05)。结论采用IADPSG的诊断阈值时,75g OGTT与100g OGTT的GDM诊断率无统计学差异,但二者通过3个点阳性诊断GDM的占比稍有不同。

妊娠期糖尿病患者OGTT不同时点血糖值异常与新生儿脑损伤关系

目的:探究GDM孕妇口服葡萄糖耐量试验(OGTT)不同时点血糖值异常与新生儿脑损伤关系。方法:回顾性纳入2022年2月—2022年9月在本院分娩的76例GDM孕妇为GDM组,健康分娩孕妇50例为对照组,产后均行新生儿行为神经测定(NBNA评分)判断是否出现脑损伤,比较两组新生儿NBNA评分及脑损伤发生率。GDM孕妇依据OGTT异常时点项目数分组,比较且新生儿NBNA评分及脑损伤发生率及相关性。结果:GDM组新生儿总NBNA评分(35.5±1.3分)均低于对照组(36.5±1.5分),脑损伤发生率(17.1%)高于对照组(4.0%)(均P<0.05);GDM孕妇新生儿服糖前、服糖后1h与2h血糖异常率分别为77.6%、55.3%、38.2%,具备1、2、3个时点项目血糖异常者占比分别为48.7%、31.6%、19.7%;随着血糖异常时点数增加,新生儿NBNA评分逐渐下降(P<0.05),血糖异常1个时点孕妇新生儿脑损伤发生率低于3个时点孕妇(2.7%比24.8%)(P<0.05);GDM孕妇服糖1h后血糖正常与异常者其新生儿一般情况、被动肌张力、行为能力等NBNA评分及脑损伤发生率存在差异(P<0.05),多元线性回归分析显示孕妇服糖1h后血糖异常与新生儿一般情况、被动肌张力、行为能力评分正相关(P<0.05)。结论:GDM孕妇OGTT不同时点血糖值异常与新生儿脑损伤具相关性,应该视孕妇OGTT每一项时点血糖值异常,及时诊断与干预,尽量避免新生儿脑损伤发生。

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。

The role of oral glucose tolerance test in screening for diabetes mellitus in the elderly of Harbin, China

Though diabetes is common worldwide, the proportion of cases diagnosed is not high. Nearly fifty percent of patients with diabetes mellitus (DM) in US are undiagnosed.~1 The ratio might be higher in China. It has been suggested that diabetes may be present 4 to 7 years before diagnosis.~2 (Many of) the complications appear to be present at the time of diagnosis of the diabetic status.~1 (Screening for) diabetes in early stage of diabetes is thus a worthwhile exercise.

Difference between 2 h and 3 h 75 g glucose tolerance test in the diagnosis of gestational diabetes mellitus(GDM):Results from a national survey on prevalence of GDM

The possibility of the 2 h oral glucose tolerance test(OGTT)as an alternative to the 3 h OGTT was investigated based on data from a national survey on pregnancy-associated diabetes.Data were retrieved from 4179 pregnant women who had OGTT performed after an abnormal 50 g glucose challenge test(GCT).All of the 4 glucose levels during their OGTT were collected and analyzed.According to American Diabetes Association(ADA)gestational diabetes mellitus(GDM)diagnostic criteria,among the 4179 pregnant women who required OGTT,3429(82.1%)were normal and 750(17.9%)were diagnosed as GDM.If the 3rd h glucose levels were omitted from OGTT,79 cases of GDM(10.5%)would be overlooked.No trend was shown where women with more risk factors were more likely to be overlooked if the 3rd h test was omitted(χ^(2) for trend=0.038,P>0.05).No significant differences were found in the rate of cesarean section(CS),preterm births or macrosomia between the 79 cases and those with normal OGTT results and in the gestational weeks when OGTT was performed.It shows that in order to diagnose one woman with GDM,another 52 pregnant women would have an innocent 3rd h glucose test.Omission of the 3rd h glucose test in OGTT might be reasonable due to its convenience,better compliance and a small number of possibly miss-diagnosed cases,and their pregnancy outcomes have no significant difference from those of normal pregnant women.

麦冬多糖MDG-1对糖尿病小鼠糖耐量及肠道菌群的影响

目的:研究不同剂量麦冬多糖(MDG-1)对自发性肥胖型二型糖尿病KKay小鼠糖耐量及肠道菌群的影响.方法:正常对照组为周龄9-10wkC57bl/6J小鼠10只,实验组为KKay糖尿病小鼠26只;小鼠9wk开始普通饲料喂养至12wk,随后高脂饲料喂养8wk.12wk时测定随机血糖>13.9mmol/L诊断为糖尿病.小鼠随机分为正常对照组、空白对照组、MDG-175、300mg/kg及罗格列酮组.正常对照组与空白对照组每天灌胃蒸馏水(10mL/kg),罗格列酮组每天灌胃2mg/kg.连续治疗8wk后,观察各组动物的一般情况,测定小鼠0、15、30、60、120min耐糖血糖值,并对各组小鼠肠道菌群进行培养,统计菌群数量.结果:不同剂量的麦冬多糖MDG-1均可在不同程度上改善KKay小鼠的多饮、多食等症状,高剂量组的效果优于低剂量组.给药8wk后,MDG-1低、高剂量均可显著降低糖尿病小鼠的空腹血糖值(P<0.05);各模型组的葡萄糖耐量均不同程度受损,MDG-1300mg/kg和阳性药罗格列酮组糖耐量均有不同程度的改善(P<0.05);糖尿病小鼠肠道内大肠杆菌和链球菌数量显著升高,而乳酸杆菌和双歧杆菌的数量明显下降,MDG-1300mg/kg组可显著降低大肠杆菌和链球菌的数量(P<0.05),对双歧杆菌的增殖也有显著作用(P<0.05).结论:不同剂量的MDG-1可以在不同程度上缓解糖尿病小鼠的糖尿病症状,改善糖耐量,调节肠道菌群平衡.

对OGTT60分钟时相高血糖老年男性患者的7年随访与转归

目的了解口服葡萄糖耐量试验（OGTT）检查时仅显示60分钟时高血糖（1hHG）患者的临床特征和转归。方法对连续7年在我院门诊行糖尿病（DM）普查时行OGTT的老年男性人群中空腹和服糖后2h血糖正常、仅服糖后1h血糖≥11．1mmol／L（OGTT-1hHG）的189患者进行随访，记录相关临床资料（包括高血压、冠心病、脑血管病等相关病史、BMI、血脂等检测指标）和每1～2年复查OGTT的情况，对可能的影响因素进行分析。结果随诊中，由OGTT-1hHG转为DM者19例（10．1％），转为糖耐最低减（IGT）者78例（41．3％），转为正常糖耐量（NGT）者2例（1．1％），保持OGTT-1hHG状态者90例（47．6％）。较同期检出IGT转为DM（21．1％）者比率低（x^2=13．05，P〈0．01），转为NGT者（0．4％）比例略高（x^2=2．46，P〉o．05）。OGTT-1hHG组合并高血压、冠心病、脑血管病及高甘油三酯血症的比例均高于NGT组（P〈0．05），与IGT组相似。结论OGTT-1h高血糖作为OGTT异常的一种特殊表现形式，是糖代谢异常的一个组成部分，其中约1／2将转为DM或IGT，也具有较多血管病变的危险因素，是一个应该关注的人群。

1100～1700nm近红外光谱无创血糖测量的OGTT实验研究

在近红外无创血糖测量的研究中 ,保证校正集模型数据的可靠性和所需的数据量具有极其重要的意义。本研究采用蠕动泵取血的 OGTT(口服葡萄糖耐量试验 )实验方法为校正集模型获取足够多的可靠血糖浓度参考值 ,并在 110 0～ 170 0 nm近红外 AOTF(声光可调谐滤波器 )分光系统基础上构建了无创血糖检测系统。利用该系统和实验方法对 3例志愿者进行实验 ,结果表明 ,建立单次实验的 PL S(偏最小二乘 )校正集模型 ,其相关系数分别为 0 .986、0 .971、0 .985 ,完全交互验证下的 RMSEP(预测均方根误差 )分别为 0 .5 5 0、0 .4 5 6、0 .5 2 0 mm ol/ l。此外 ,随着有效数据量增加 ,所建立模型的预测误差减小。

妊娠糖尿病患者孕中晚期血清GLP-1水平变化及临床意义

目的探讨妊娠糖尿病(GDM)患者孕中晚期血清胰高血糖素样肽1(GLP-1)水平变化及临床意义。方法选取规律产检孕妇82例,其中GDM患者40例(GDM组),糖耐量正常者42例(对照组)。两组均于孕24~28周行75 g口服葡萄糖耐量试验(OGTT),分别于糖负荷后0、30、60、120 min时检测血清GLP-1及GLP-1曲线下面积(AUCGLP-1),分别计算糖负荷后0、30、60、120 min时胰岛素(INS)/GLP-1及胰岛素曲线下面积(AUCINS)/AUCGLP-1。分析GDM患者血清GLP-1、AUCGLP-1与血糖(GLU)、血糖曲线下面积(AUCGLU)、INS及AUCINS的相关性。结果 GDM组糖负荷后30 min时INS/GLP-1低于对照组(P<0.05),两组各时间点血清GLP-1水平及AUCGLP-1、AUCINS/AUCGLP-1比较差异均无统计学意义(P均>0.05)。GDM患者血清GLP-1与糖负荷后0、30、60、120 min时GLU、INS及AUCGLU均不相关(P均>0.05),GLP-1及AUCGLP-1均与AUCINS呈正相关(r分别为0.243、0.270,P均<0.05),糖负荷后60、120 min时AUCGLP-1与INS呈正相关(r分别为0.013、0.041,P均<0.05)。结论与糖耐量正常孕妇相比,GDM患者血清GLP-1水平存在峰值延后倾向,在75 g OGTT糖负荷后30 min可能存在GLP-1分泌相对不足,提示GDM患者可能存在GLP-1抵抗。