口服葡萄糖耐量试验重复性调查及其临床应用价值

目的调查75g口服葡萄糖耐量试验（OGTT）诊断糖代谢异常的重复性。方法259例既往未诊断糖尿病的受试人群（男152例,女107例）间隔2～3周重复进行两次OGTT。结果OGTT总体重复率为56．4％。根据第一次OGTT结果把人群分为糖耐量正常、糖调节受损（IGR）和糖尿病3组,其重复率分别为91．2％、37．5％和63．8％,组间比较差异有统计学意义（P〈0．05）。根据人群所含的代谢异常组分个数的不同分组,发现具有2个代谢异常组分的人群OGTT重复率明显低于代谢异常组分小于或大于2个的人群（P值均〈0．05）。两次OGTT结果为正常．异常组的年龄、血压、心率和腰臀围比明显高于正常-正常组（P值均〈0．05）,异常-异常组的腰围和TG高于、HDL-C低于正常-异常组,其他临床特征差异无统计学意义。结论OGTT总体重复率较低,在IGR人群和中度代谢异常人群中尤为显著。与正常人群相比,只要一次OGTT显示为异常的人群就具有较多的心血管病危险因子,因此虽然OGTT重复性较低,但是对糖代谢异常的筛查仍具有重要的实践意义。

The reproducibility and clinical significance of oral glucose tolerance test for abnormal glucose metabolism

OBJECTIVES: To examine the reproducibility of oral glucose tolerance test (OGTT) in screening abnormal glucose metabolism in Chinese population. METHODS: Two times of OGTT were performed in 259 Chinese subjects without a history of diabetes (male 152, female 107) over a period of 2-3 weeks. RESULTS: The overall reproducibility was 56.4%. Subjects with impaired glucose regulation (IGR) at the first test showed lower reproducibility (37.5%), as compared with subjects with normal glucose metabolism (91.2%) and newly detected diabetes (63.8%). The reproducibility of OGTT in group with two components of metabolic syndrome is the lowest (P < 0.05). According to the results of the two tests, subjects with one abnormal OGTT had older, higher systolic blood pressure, heart rate and waist-to-hip ratio (WHR) than those with two normal OGTTs and had lower waist circumference, triglyceride and higher high-density lipoprotein cholesterol than those with two abnormal OGTTs. CONCLUSIONS: These findings confirmed the poor reproducibility of OGTT which was lower in subjects with IGR and moderate metabolic abnormality. Furthermore, subjects with one abnormal OGTT, whether reproducible or not, had a higher cardiovascular risk profile, as compared with subjects with normal glucose regulation on two OGTTs. Therefore, OGTT is still essential to the screening of abnormal glucose metabolism.