| 张 琳,董 鹏,李友芳,李宇君,汪 宁,薛阳利,黄丽丽.口服葡萄糖耐量试验负荷后1小时血糖筛查糖调节受损和糖尿病的最佳切点值及糖调节受损患者转归的随访研究[J].,2023,(19):3642-3645 |
| 口服葡萄糖耐量试验负荷后1小时血糖筛查糖调节受损和糖尿病的最佳切点值及糖调节受损患者转归的随访研究 |
| The Best Cut-off Point Value of Impaired Glucose Regulation and Diabetes in Blood Glucose Screening 1 h after Oral Glucose Tolerance Test Loading and the Follow-up Study of Patients with Impaired Glucose Regulation |
| 投稿时间：2023-03-05 修订日期：2023-03-26 |
| DOI：10.13241/j.cnki.pmb.2023.19.008 |
| 中文关键词: 口服葡萄糖耐量试验 糖调节受损 糖尿病 切点值 转归 |
| 英文关键词: Oral glucose tolerance test Impaired glucose regulation Diabetes mellitus Cut-off point values Prognosis |
| 基金项目:陕西省社会发展科技攻关项目（2016SF-106） |
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| 中文摘要: |
| 摘要 目的：研究分析口服葡萄糖耐量试验（OGTT）负荷后1 h血糖筛查糖调节受损（IGR）和糖尿病（DM）的最佳切点值及糖调节受损患者转归的随访结果。方法：选择2018年6月-2019年6月于西安交通大学第二附属医院行OGTT试验的340例受试者。采用受试者工作特征（ROC）曲线分析OGTT负荷后餐后1h血糖（1hPG）筛查DM及IGR的切点值。按照上述切点值将受试者分为正常组81例，IGR组106例，DM组153例。对比三组人员胰岛功能及血脂指标水平。对IGR组患者进行为期3年的随访观察，将其按照随访结果的差异分为进展组35例与无进展组71例。以单因素及多因素Logistic回归分析进展成DM的危险因素。结果：经ROC曲线分析，OGTT负荷后1hPG筛查IGR的最佳切点值为10.0 mmol/L，筛查DM的最佳切点值为13.0 mmol/L。正常组、IGR组及DM组胰岛素抵抗指数（HOMA-IR）、总胆固醇（TG）水平均呈逐渐升高趋势，β细胞功能指数（HOMA-β）呈逐渐降低趋势，且经单因素方差分析发现：各组间对比差异均有统计学意义（均P＜0.05）。进展组年龄、体质量指数（BMI）及TG水平均高于无进展组（均P＜0.05）。经多因素Logistic回归分析发现：年龄高、高BMI及高TG水平均是IGR患者进展成DM的独立危险因素（均P＜0.05）。结论：OGTT负荷后1 h血糖筛查IGR的切点值为10.0 mmol/L，筛查DM的切点值为13.0 mmol/L，且1hPG可有效反映胰岛功能及血脂水平。此外，IGR患者转归的影响因素与年龄、BMI及TG有关。 |
| 英文摘要: |
| ABSTRACT Objective: To study and analyze the best cut-off point value of impaired glucose regulation (IGR) and diabetes mellitus (DM) in blood glucose screening 1 h after oral glucose tolerance test (OGTT) loading and the follow-up results of IGR patients. Methods: 340 subjects who were received OGTT at the Second Affiliated Hospital of Xi'an Jiaotong University from June 2018 to June 2019 were selected. Receiver operating characteristic (ROC) curves were used to analyze the cut point values for screening DM and IGR with 1-hour postprandial blood glucose (1hPG) after OGTT loading. According to the above cutoff values, the subjects were divided into normal group (81 cases), IGR group (106 cases), and DM group (153 cases). Pancreatic islet function and blood lipid levels among three groups were compared. A 3-year follow-up observation was conducted on patients in the IGR group, who were divided into progression group of 35 cases and non-progression group of 71 cases according to the differences in follow-up results. The risk factors for progression to DM were analyzed using univariate and multivariate Logistic regression. Results: After ROC curve analysis, the optimal cutoff point value for IGR screening with 1hPG after OGTT loading was 10.0 mmol/L, the optimal cutoff point value for DM screening was 13.0 mmol/L. The homeostasis model assessment of insulin resistant (HOMA-IR), and total cholesterol (TG) levels in normal group, IGR group, and DM group all showed a gradually increasing trend, while homeostasis model assessment of β cell function (HOMA-β) gradually decreasing trend, and univariate analysis of variance showed statistically significant differences among all groups (all P<0.05). Age, body mass index (BMI) and TG level in progression group were higher than those in non-progression group (all P<0.05). Multiple Logistic regression analysis showed that high age, high BMI and high TG level were independent risk factors for progression to DM in IGR patients (all P<0.05). Conclusion: The cut-off point value of IGR for blood glucose screening at 1h after OGTT loading is 10.0 mmol/L, the cut-off point value for screening DM is 13.0 mmol/L, and 1hPG can effectively reflect pancreatic islet function and blood lipid levels. In addition, the influencing factors of IGR patients' prognosis are related to age, BMI, and TG. |
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