某部82例糖耐量低减者五年后的转归

为了解糖耐量低减 (IGT)患者的转归及其影响因素 ,我们对 1994年我部在京人员按 WHO标准诊断的 82例 IGT患者于 1999年进行复查。一、对象和方法1.对象 :1994年在我部留京工作人员糖尿病流行病学调查中 ,按口服 75 g葡萄糖耐量试验 (OGTT)诊断的 IGT患者共 93例 ,其中 82例 (男     

行为和药物干预治疗糖耐量低减疗效比较

本临床研究共设4组：对照组（n=30）;饮食和运动治疗组（n=28）;拜唐苹治疗组（n=29）;文迪雅治疗组（n=32）。观察时间为6个月。饮食加运动组按个体情况安排饮食及运动方案,每月重复宣教饮食及运动的治疗意义;拜唐苹50mg每日3次,文迪雅4mg每日1次。结果：对照组治疗后,体重指数（BMI）、空服血糖（FPG）、餐后2h血糖（PPG）、总胆固醇（TC）、甘油三脂（TG）、低密度脂蛋白胆固醇（LDL）、空腹胰岛素（FInS）等有上升趋势,但无统计学差异（P〉0.05）。饮食加运动治疗组,上述各指标有不同程度下降（P〉0.05）。拜唐苹治疗组和文迪雅治疗组各指标,明显下降,具有统计学差异（P〈0.01）。后高密度脂蛋白胆固醇（HDL）（P〉0.05）。结论：对IGT患者在饮食,运动的基础上有必要给予拜唐苹、文迪雅等药物干预治疗。     

不同糖耐量水平者C反应蛋白与内皮功能的相关性研究

内皮功能障碍是发生动脉粥样硬化的“启动子”。C反应蛋白（CRP）是一种敏感的非特异性的炎症标记物。糖耐量低减（IGT）是糖尿病（DM）发生前的一个临床阶段，IGT患动脉硬化性血管病变的发生率已经高于糖耐量正常（NGT）人群。本研究通过对不同糖耐量水平高敏CRP水平进行比较分析，探讨IGT及DM患炎症标记物与内皮功能的关系。     

应切实加强对葡萄糖耐量低减人群的管理

１９８９年世界卫生组织通过关于“糖尿病的预防和控制的决议”，此后糖尿病的防治引起了世界各国的广泛关注。我国已将糖尿病研究列入国家计划，并于１９９６年成立了糖尿病专家咨询委员会，表明防治糖尿病已成为政府行为。这一切对我国糖尿病预防和治疗起了重要的推动作...     

蚌埠地2型糖尿病防治研究25年资料分析

1980年16844人中普查出的144例72DM及24例IGT者予生活方式及药物干预，25年后对此人群进行跟踪。结果：72DM先后服用降糖药治疗者〉17．6％；应用胰岛素或与口服降血糖药联用或先后阶段性应用大约占79．4％；仅以饮食和体育锻炼治疗者2．9％。4例T2DM患者逆转为IGT。病死率为70．2％（80／114），死因为心脑血管病、多脏器功能衰竭、慢性肾功能不全、恶性肿瘤等。IGT者失访2例，13．6％发展成DM，40．9％仍为IGT，45．5％转为NGT。结论：DM是可防的．应做到早发现、综合干预、强化治疗。     

二甲双胍干预治疗葡萄糖耐量减低临床分析

应用二甲双胍干预治疗葡萄糖耐量减低（IGT）患者,分析探讨其临床应用价值。方法：选择100例临床确诊的IGT患者,随机分为二组,对照组47例,予以锻炼,饮食控制等生活方式干预。二甲双胍组在上述锻炼、生活方式干预基础上应用二甲双胍250mg每日3次,持续3个月后,二甲双胍组较对照组糖尿病发病率明显下降,同时体重指数（BMI）血脂（TC、LDL-C）等方面较对照组明显下降,差异有统计学意义（P〈0．05）。     

糖耐量低减的特征及其与冠心病发生的关联

对大庆市25岁以上28万人口中的108, 660人进行糖尿病调查,按WHO标准,诊断糖耐量低减(IGT)有596例,糖尿病630例,两者检出率分别为5.5‰与5.8‰。原已发现的糖尿病有190例。与年龄、性别相配比的糖耐量正常对照组521例比较,IGT者高血压、肥胖患病率高2倍(分别为35.3和61％);高脂蛋白血症较多;冠心病患病率(3.76％)高8.9倍,尿白蛋白排泄率高2倍。IGT者伴有高胰岛素血症,但口服葡萄糖耐量试验1小时胰岛素释放指数低于对照组,故胰岛素抵抗与胰岛分泌功能障碍同时存在。多因素分析,除外年龄、高脂蛋白血症、高血压、肥胖等因素的影响,IGT无症状轻度高血糖状态亦为冠心病的危险因素。     

行为和药物干预治疗糖耐量低减疗效比较

本临床研究共设4组对照组(n=30);饮食和运动治疗组(n=28);拜唐苹治疗组(n=29);文迪雅治疗组(n=32).观察时间为6个月.饮食加运动组按个体情况安排饮食及运动方案,每月重复宣教饮食及运动的治疗意义;拜唐苹50mg每日3次,文迪雅4mg每日1次.结果对照组治疗后,体重指数(BMI)、空服血糖(FPG)、餐后2h血糖(PPG)、总胆固醇(TC)、甘油三脂(TG)、低密度脂蛋白胆固醇(LDL)、空腹胰岛素(FInS)等有上升趋势,但无统计学差异(P＞0.05).饮食加运动治疗组,上述各指标有不同程度下降(P＞0.05).拜唐苹治疗组和文迪雅治疗组各指标,明显下降,具有统计学差异(P＜0.01).后高密度脂蛋白胆固醇(HDL)(P＞0.05).结论对IGT患者在饮食,运动的基础上有必要给予拜唐苹、文迪雅等药物干预治疗.     

糖耐量低减患者动态血压的改变

为观察糖耐量低减（ＩＧＴ）患者动态血压（ＡＢＰＭ）的改变，对血压正常和血压增高的ＩＧＴ患者各２０例进行２４小时ＡＢＰＭ监测及各项生化指标检查，并设有糖耐量正常组和糖尿病组进行对照研究。结果ＩＧＴ患者２４小时ＡＢＰＭ的变化与糖耐量正常者相似，但具有夜间血压增高和昼夜血压差值减小的趋势。血压昼夜节律异常的ＩＧＴ患者ＡＢＰＭ的改变为夜间血压升高。表明ＩＧＴ患者已开始出现早期的血压改变。     

糖耐量异常患者ApoE表型与高脂血症关系

本文对92例糖尿病病人,174例糖耐量低减病人及124例糖耐量正常人的ApoE表型与高脂血症关系的研究表明,糖耐量异常患者ApoE表型异常主要表现为E_(3/3)明显减少、E_(2/3)显著升高。高脂血症主要与血糖的升高呈正相关,但反映遗传基因不同的ApoE表型也与高脂血症有关。     

用改进的最小模型对糖耐量减退和Ⅱ型糖尿病患者胰岛素抵抗致病机制的研究

用改进的最小模型分别对正常人、IGT(糖耐量减退)和NIDDM(II型糖尿病)患者进行胰岛素敏感指数(S_1)、胰岛素自身代谢效能(S_G)及胰岛β细胞功能分析.结果表明:改进的最小模型与标准的最小模型相比较,两种方法对评估S_1和S_G有高度的相关性(S_1·r=0.856,P相似文献   

城市居民体重指数与糖尿病和糖耐量低减关系的研究

目的 分析南宁市城市居民体重指数（BMI）与糖尿病（DM）发病的关系。方法 对南宁市样本区随机抽取5个街道社区（居委会）810户，每户抽取年龄在35-74岁的居民1人，共810人。分别检测体重、体重指数（BMI）、餐后12h空腹血糖（FPC）；按DM糖耐量低减（IGT）诊断标准分别计算各组的患病率并对照比较。结果 DM患病率以65-74岁组最高，达14．56％；IGT患病率以55-64岁组最高，达16．28％；BMI肥胖组DM、IGT患病率均比正常体重组高，分别高出8．49％及14．48％；不同性别DM、IGT患病率无明显差异。结论 南宁市城市居民DM与IGT的患病情况与年龄呈正比关系，提示超重和肥胖是DM的重要危险因素之一；DM及IGT在南宁市城市居民中已占有相当大的比例。     

硝苯地平(硝苯吡啶)对原发性高血压患者葡萄糖耐量及血脂的影响

对37例原发性高血压患者口服硝苯地平(硝苯毗啶)(最大剂量30mg/日)前后葡萄糖耐量和血脂变化进行了一个月临床观察。结果表明,硝苯地平对原发性高血压患者葡萄糖耐量无不利影响,能显著降低血清甘油三酯(TG)、总胆固醇(TC)和升高高密度脂蛋白胆固醇(HDL-C、HDL_2-C)及HDL-C/TC。     

432例糖耐量减低患者二年的演变

对1986年诊断的432例糖耐量减低(IGT)者,于1988年进行复查,IGT每年约7.7％发展为糖尿病(DM)。原空腹及服糖后1、2小时血糖较高的IGT者易发展为DM,可能为长期胰岛素抵抗,胰岛对持续高血糖刺激分泌胰岛素的功能失代偿所致。原血糖较低及控制体重的IGT者易恢复正常,并显示胰岛素抵抗减轻及胰岛素分泌功能改善。IGT者转为DM及正常组后血压降低,可能与血浆胰岛素水平降低有关。     

Loss of the First Phase Insulin Response to Intravenous Glucose in Subjects with Persistent Impaired Glucose Tolerance

Loss of the first phase insulin response to intravenous glucose is one of the earliest detectable defects of beta cell dysfunction in Type 2 diabetes mellitus. Impaired glucose tolerance (IGT) is considered a prediabetic condition, therefore loss of first phase insulin secretion in subjects with IGT would suggest beta cell dysfunction as an early lesion in the development of Type 2 diabetes. Three groups of subjects were studied, 7 subjects with persistent IGT (classified as having IGT at two 75 g oral glucose tolerance tests (OGTT) done 6 months apart), 6 subjects with transient IGT (IGT at the first OGTT, but normal glucose tolerance at a repeat OGTT 6 months later), and 7 normal controls. First phase insulin secretion was studied using an intravenous glucose tolerance test with arterialized blood sampling. Fasting, 3, 4 and 5 min samples were assayed for glucose and insulin (specific two-site immunoradiometric assay). The fasting insulin was similar in all three groups, however the 3 min insulin response was significantly lower in those with persistent impaired glucose tolerance (p < 0.02). Thus subjects with persistent impaired glucose tolerance demonstrated loss of the first phase insulin response as an early indicator of beta cell dysfunction while subjects with transient IGT had a normal insulin response to intravenous glucose. During the OGTT, the 30 min glucose was not significantly different (p = 0.1) but the 30 min insulin to glucose ratio was significantly lower in subjects with persistent IGT (p < 0.03). In the whole group the 30 min insulin to glucose ratio during the OGTT showed a significant correlation with the peak insulin response during the IVGTT (r = 0.76, p < 0.001). This study suggests that beta cell dysfunction with impaired early insulin release is present before the development of Type 2 diabetes.     

The relationship between blood glucose concentration and beat-to-beat variation in asymptomatic subjects

Summary Very little is known about the presence of autonomic neuropathy in subjects with slight abnormalities of glucose metabolism. This study was carried out to investigate whether impaired glucose tolerance (IGT) is associated with abnormalities of beat-to-beat variation (BTBV). Sixty-two subjects, aged 40–59 years, with IGT (according to EASD criteria) and 124 normals, matched for age, sex and body mass index (BMI), were selected among the participants in a health examination survey and tested for BTBV. Among the possible factors influencing this test, sex did not show any effect, while age and BMI were significantly and negatively correlated to BTBV in both groups. Glucose intolerance was not associated with any impairment of BTBV which was almost identical in the normal (15.8±6.3 beats/min) (mean ± SD) and in the IGT group (16.7±7.0 beats/min). Similarly no significant difference was found in BTBV between subjects with constant IGT or normal results at OGTT, repeated on two occasions. All subjects were then stratified according to blood glucose values 2 h after an oral glucose load (after load): only those with blood glucose after load >200 mg/dl displayed a significant decrease in BTBV (9.7±3.8 beats/min) compared to those found normal at the glucose tolerance test (p<0.025). They were also the only ones with an average HbA₁ level significantly higher than in normal individuals (p<0.005). In conclusion, IGT is not associated with abnormalities of BTBV. Presented in part at the 17th Annual Meeting of EASD, Amsterdam, 1981.     

Nonalcoholic fatty liver is a risk factor for postprandial hyperglycemia, but not for impaired fasting glucose

Purpose  The first aim of this study was to elucidate the relationship between impaired glucose tolerance (IGT) and nonalcoholic fatty liver. The second was to make a rule regarding to whom 75-g oral glucose tolerance tests (OGTTs) should be applied to identify subjects with IGT and diabetes mellitus (DM) in the annual check-up at the human dry dock. Methods  A total of 716 subjects who visited the Department of General Medicine of the International Medical Center of Japan from May 2001 through January 2008 for an annual check-up at the human dry dock were analyzed. We evaluated risk factors related to nonalcoholic fatty liver using multivariate logistic regression analysis and compared the difference of body mass index (BMI) and glucose level at 75-g OGTT at two different time points in subjects whose fatty change had improved or worsened. Results  Nonalcoholic fatty liver was strongly related to 2-h- and 1-h-post-challenge glucose level (P < 0.0001 and P = 0.018, respectively), but not fasting plasma glucose (FPG) (P = 0.706). The risk factors for IGT were nonalcoholic fatty liver (P < 0.05), low levels of high-density lipoprotein cholesterol (HDL-C) (P = 0.026) and age (P = 0.013). A clearly positive relationship was observed between the difference of BMI and 2-h-post-challenge glucose level among the subjects whose fatty change had improved or worsened (R = 0.6, P = 0.018). Conclusions  Nonalcoholic fatty liver was clearly related to the 2-h- or 1-h-post-challenge glucose level, but not to FPG, in 75-g OGTT, and this IGT was corrected by body weight reduction in accordance with diminished nonalcoholic fatty liver. Thus, 75-g OGTT should be applied to subjects with nonalcoholic fatty liver to evaluate IGT.     

Abnormal Glucose Tolerance in β-Thalassemia: Assessment of Risk Factors

In β-thalassemia (β-thal) major, the pathogenetic mechanisms leading from siderosis to diabetes are poorly understood. We assessed the glycometabolic status in transfusion-dependent Egyptian β-thal patients and evaluated their possible risk factors for abnormal glucose tolerance (AGT). An oral glucose tolerance test (OGTT) was done on 54 multi-transfused patients and 28 age-matched normal controls, measuring their serum insulin levels at 0 and 120 min. Insulin sensitivity and insulin release indices were calculated. Indicators of iron overload and liver status were recorded. Thirteen patients (24.1%) had AGT. Cases with AGT had significantly higher mean postprandial insulin, fasting insulin resistance index (FIRI) and homeostasis model assessment (HOMA) insulin resistance (IR), p?=?0.0001 for all, and significantly lower mean HOMA β cell, p?=?0.007, when compared with normal glucose tolerance (NGT) cases. Abnormal glucose tolerance is common in multi-transfused β-thal major patients and could be attributed to early impaired β-cell function with increasing IR.