Investigating the Postprandial Metabolome after Challenge Tests to Assess Metabolic Flexibility and Dysregulations Associated with Cardiometabolic Diseases

This review focuses on the added value provided by a research strategy applying metabolomics analyses to assess phenotypic flexibility in response to different nutritional challenge tests in the framework of metabolic clinical studies. We discuss findings related to the Oral Glucose Tolerance Test (OGTT) and to mixed meals with varying fat contents and food matrix complexities. Overall, the use of challenge tests combined with metabolomics revealed subtle metabolic dysregulations exacerbated during the postprandial period when comparing healthy and at cardiometabolic risk subjects. In healthy subjects, consistent postprandial metabolic shifts driven by insulin action were reported (e.g., a switch from lipid to glucose oxidation for energy fueling) with similarities between OGTT and mixed meals, especially during the first hours following meal ingestion while differences appeared in a wider timeframe. In populations with expected reduced phenotypic flexibility, often associated with increased cardiometabolic risk, a blunted response on most key postprandial pathways was reported. We also discuss the most suitable statistical tools to analyze the dynamic alterations of the postprandial metabolome while accounting for complexity in study designs and data structure. Overall, the in-depth characterization of the postprandial metabolism and associated phenotypic flexibility appears highly promising for a better understanding of the onset of cardiometabolic diseases.     

葡萄糖耐量试验在空腹血糖正常高脂血症患者早期诊断糖尿病中的应用

目的探讨葡萄糖耐量试验在空腹血糖正常高脂血症患者早期诊断糖尿病中的应用价值。方法选择秦皇岛市第四医院体检确诊的100例空腹血糖正常的单纯高脂血症患者,行葡萄糖耐量试验(OGTT),2 h后测定受检者2 h血糖(2hPG),分析葡萄糖耐量降低(IGT)及糖尿病检出情况,并比较正常组、IGT组及糖尿病组患者FPG、2hPG、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、谷草转氨酶(AST)、谷丙转氨酶(ALT)水平。结果 OGTT检出IGT 37例(37%),糖尿病27例(27%);IGT组及糖尿病组2hPG较正常组显著升高(P<0.05、P<0.01);三组TG、TC、LDL-C均高于正常值,糖尿病组TG、TC、LDL-C较正常组显著升高(P<0.05),而IGT组TG、TC、LDL-C与正常组差异无统计学意义(P>0.05);三组ALT及AST均在正常范围内,组间差异无统计学意义(P>0.05)。结论 OGTT试验可早期诊断空腹血糖正常的高脂血症患者的糖代谢异常,值得临床推广应用。     

Comparing the Fasting and Random-Fed Metabolome Response to an Oral Glucose Tolerance Test in Children and Adolescents: Implications of Sex,Obesity, and Insulin Resistance

As the incidence of obesity and type 2 diabetes (T2D) is occurring at a younger age, studying adolescent nutrient metabolism can provide insights on the development of T2D. Metabolic challenges, including an oral glucose tolerance test (OGTT) can assess the effects of perturbations in nutrient metabolism. Here, we present alterations in the global metabolome in response to an OGTT, classifying the influence of obesity and insulin resistance (IR) in adolescents that arrived at the clinic fasted and in a random-fed state. Participants were recruited as lean (n = 55, aged 8–17 years, BMI percentile 5–85%) and overweight and obese (OVOB, n = 228, aged 8–17 years, BMI percentile ≥ 85%). Untargeted metabolomics profiled 246 annotated metabolites in plasma at t0 and t60 min during the OGTT. Our results suggest that obesity and IR influence the switch from fatty acid (FA) to glucose oxidation in response to the OGTT. Obesity was associated with a blunted decline of acylcarnitines and fatty acid oxidation intermediates. In females, metabolites from the Fasted and Random-Fed OGTT were associated with HOMA-IR, including diacylglycerols, leucine/isoleucine, acylcarnitines, and phosphocholines. Our results indicate that at an early age, obesity and IR may influence the metabolome dynamics in response to a glucose challenge.     

Changes in glucose tolerance during three years'' follow-up in an elderly population

The aim of this study was to describe changes in glucose tolerance over 3 y and to establish the prevalence of diabetes and impaired glucose tolerance in an unselected non-institutionalised elderly population aged 70 y or over at the beginning of the study. Diabetes was assessed on the basis of self-reports and 2 h oral glucose tolerance tests which were classified according to the 1985 WHO criteria.At the end of the follow-up period, 15% (n=14) of the men were diagnosed as having previously diagnosed diabetes, 8% (n=7) as having previously undiagnosed diabetes, 36% (n=33) as having IGT and the remaining 41% (n=38) as having normal glucose tolerance. The corresponding figures for the women were: 22% (n=37), 8% (n=13), 37% (n=61) and 34% (n=56), respectively.More than one third of the people with baseline normal glucose tolerance (NGT) had progressed to impaired glucose tolerance (IGT) or diabetes mellitus (DM) (n=44). Almost one third of those with baseline IGT had reverted to NGT (n=24), half had persisting IGT (n=41) and one fifth had progressed to DM (n=14). Almost one fifth of the subjects with baseline DM had reverted to IGT (n=12), and only one had reverted to NGT.In conclusion, a comparatively high proportion of both previously diagnosed diabetes, previously undiagnosed diabetes and IGT were found in the follow-up examinations of this elderly study population. The rate of deterioration of glucose tolerance during 3 y follow-up was also moderately high among these elderly subjects.     

Oral Intake of L-Ornithine-L-Aspartate Is Associated with Distinct Microbiome and Metabolome Changes in Cirrhosis

L-ornithine L-aspartate (LOLA) is administered as a therapeutic and/or preventive strategy against hepatic encephalopathy either intravenously or orally in patients with liver cirrhosis. Here, we analyzed how LOLA influences the microbiome and metabolome of patients with liver cirrhosis. We retrospectively analyzed the stool microbiome, stool, urine and serum metabolome as well as markers for gut permeability, inflammation and muscle metabolism of 15 cirrhosis patients treated orally with LOLA for at least one month and 15 propensity-score-matched cirrhosis patients without LOLA. Results were validated by comparing the LOLA-treated patients to a second set of controls. Patients with and without LOLA were comparable in age, sex, etiology and severity of cirrhosis as well as PPI and laxative use. In the microbiome, Flavonifractor and Oscillospira were more abundant in patients treated with LOLA compared to the control group, while alpha and beta diversity were comparable between groups. Differences in stool and serum metabolomes reflected the pathophysiology of hepatic encephalopathy and confirmed LOLA intake. In the urine metabolome, ethanol to acetic acid ratio was lower in patients treated with LOLA compared to controls. LOLA-treated patients also showed lower serum levels of insulin-like growth factor (IGF) 1 than patients without LOLA. No differences in gut permeability or inflammation markers were found. A higher abundance of Flavonifractor and Oscillospira in LOLA-treated patients could indicate LOLA as a potential microbiome modulating strategy in patients with liver disease. The lower levels of IGF1 in patients treated with LOLA suggest a possible link between the pathophysiology of hepatic encephalopathy and muscle health.     

妊娠期糖尿病孕产妇葡萄糖耐量试验不同时点血糖异常对妊娠结局的影响

目的：研究妊娠期糖尿病(GDM)孕产妇口服葡萄糖耐量试验(OGTT)不同时点血糖指标异常对妊娠结局的影响。方法：选择2018年10月—2020年11月在南通市妇幼保健院定期进行产前检查并分娩的373例GDM孕产妇作为研究对象。孕产妇在孕24～28周时,行口服75 g葡萄糖耐量试验,其中仅1项血糖升高为Ⅰ组(空腹血糖升高为Ⅰ-A组,1 h血糖升高为Ⅰ-B组,2 h血糖升高为Ⅰ-C组);2项血糖升高为Ⅱ组(空腹及1 h血糖升高为Ⅱ-A组,空腹及2 h血糖升高为Ⅱ-B组,1 h及2 h血糖升高为Ⅱ-C组);3项血糖升高为Ⅲ组。分析GDM孕产妇妊娠结局。结果：(1)Ⅱ组、Ⅲ组孕产妇的孕次多于Ⅰ组(t值分别为8.601和7.491,P值均<0.05),Ⅲ组不良孕产史的发生率高于Ⅰ组(χ²=9.608,P<0.05);(2)Ⅲ组孕产妇妊娠期高血压和羊水异常发病率均高于Ⅰ组和Ⅱ组(Ⅰ组χ²值分别为11.483、6.757,Ⅱ组χ²值分别为5.106、7.163,P值均<0.05);(3)Ⅰ-A组孕产妇妊娠期高血压发生...     

联合检测血糖、糖化血清蛋白在妊娠期糖筛查中的价值

目的:探讨联合检测血糖、糖化血清蛋白(GSP)在妊娠期糖代谢异常孕妇中的价值。方法:对正常妊娠组、糖筛查异常组及糖耐量异常组进行空腹葡萄糖、口服葡萄糖50g筛选,GSP测定并随访孕妇和围产儿的最终结局进行分析比较。结果:糖筛查异常组GSP(154±18)μmol/L、糖耐量异常组GSP(157±26)μmol/L,与正常妊娠组GSP(136±30)μmol/L比较,差异有统计学意义(P0.01),不同的GSP水平围产儿病率差异有统计学意义。结论:GLU、GSP联合检测在妊娠期糖筛查中有较高的临床应用价值。     

Metabolic Effects of an Oral Glucose Tolerance Test Compared to the Mixed Meal Tolerance Tests: A Narrative Review

The oral glucose tolerance test (OGTT) is recommended for assessing abnormalities in glucose homeostasis. Recognised as the gold standard test for diagnosing diabetes, the OGTT provides useful information about glucose tolerance. However, it does not replicate the process of absorption and digestion of complex foods, such as that which occurs with a mixed meal tolerance test (MMTT), an alternative that is still not well explored in the diagnosis of metabolic alterations. The MMTT could be an asset in detecting glucose homeostasis disorders, including diabetes since it has more similarities to the common dietary pattern, allowing early detection of subtle changes in metabolic homeostasis in response to combined nutrients. This alternative has the advantage of being more tolerable and pleasant to patients since it induces a more gradual increase in blood glucose, thus reducing the risk of rebound hypoglycemia and other related complications. The present article reviewed the clinical data available regarding the possibility of screening or diagnosing altered glucose homeostasis, including type 2 diabetes mellitus, with the MMTT.     

Coplanar Polychlorinated Biphenyls Impair Glucose Homeostasis in Lean C57BL/6 Mice and Mitigate Beneficial Effects of Weight Loss on Glucose Homeostasis in Obese Mice

Background: Previous studies demonstrated that coplanar polychlorinated biphenyls (PCBs) promote proinflammatory gene expression in adipocytes. PCBs are highly lipophilic and accumulate in adipose tissue, a site of insulin resistance in persons with type 2 diabetes.Objectives: We investigated the in vitro and in vivo effects of coplanar PCBs on adipose expression of tumor necrosis factor α (TNF-α) and on glucose and insulin homeostasis in lean and obese mice.Methods: We quantified glucose and insulin tolerance, as well as TNF-α levels, in liver, muscle, and adipose tissue of male C57BL/6 mice administered vehicle, PCB-77, or PCB-126 and fed a low fat (LF) diet. Another group of mice administered vehicle or PCB-77 were fed a high fat (HF) diet for 12 weeks; the diet was then switched from HF to LF for 4 weeks to induce weight loss. We quantified glucose and insulin tolerance and adipose TNF-α expression in these mice. In addition, we used in vitro and in vivo studies to quantify aryl hydrocarbon receptor (AhR)-dependent effects of PCB-77 on parameters of glucose homeostasis.Results: Treatment with coplanar PCBs resulted in sustained impairment of glucose and insulin tolerance in mice fed the LF diet. In PCB-77–treated mice, TNF-α expression was increased in adipose tissue but not in liver or muscle. PCB-77 levels were strikingly higher in adipose tissue than in liver or serum. Antagonism of AhR abolished both in vitro and in vivo effects of PCB-77. In obese mice, PCB-77 had no effect on glucose homeostasis, but glucose homeostasis was impaired after weight loss.Conclusions: Coplanar PCBs impaired glucose homeostasis in lean mice and in obese mice following weight loss. Adipose-specific elevations in TNF-α expression by PCBs may contribute to impaired glucose homeostasis.     

青岛地区妊娠期糖尿病发病率及临床资料分析

目的 探讨青岛地区妊娠期糖尿病的发病率及对妊娠结局的影响,以指导临床早期干预及治疗妊娠期糖尿病,减少母婴并发症.方法 选取2014年3月至2015年5月在青岛大学附属医院东区分娩的孕产妇,孕妇24-28周空腹血糖≥5.1 mmol/L或行75g葡萄糖耐量试验(OGTT)任意一点血糖异常即诊断为妊娠糖尿病(GDM).收集到病例组(GDM组)670人,其中OGTT结果 仅1项血糖异常为GDM A组,2项血糖异常为GDM B组,3项血糖异常为GDM C组,随机选择同期非妊娠期糖尿病孕产妇727例作为对照组,对不同组间的妊娠结局进行分析.结果 ①GDM的患病率为24.17%;②GDM组的年龄、孕次及产次、孕前后体重及孕前后BMI均高于对照组(t值分别为5.545、2.990、2.782、4.494、3.930、5.355、4.980,均P<0.05);③GDM组孕产妇胎膜早破、早产、剖宫产、妊娠期高血压的发生率均高于对照组(χ2值分别为3.928、5.181、26.788、4.975,均P<0.05);④GDM组新生儿巨大儿、胎儿窘迫的发生率均高于对照组(χ2值分别为6.363、4.299,均P<0.05);GDM组新生儿出生孕周小于对照组(t=-2.844,P<0.05);GDM组新生儿出生体重高于对照组(t=3.664,P<0.05);⑤GDM C组在胎膜早破、剖宫产、巨大儿的发生率较对照组均显著升高(χ2值分别为9.984、8.809、22.971,均P<0.01);而GDM A组和GDM B组仅剖宫产率较对照组升高(χ2值分别为11.749、21.691,均P<0.01);除了巨大儿发生率在GDM A组与GDM C组、GDM B组与GDM C组之间差异有统计学意义(χ2值分别为14.474、7.461,均P<0.01)之外,其他各组之间妊娠结局差异无统计学意义.结论 GDM与年龄、孕产史及孕前后体重和BMI有关,OGTT多项血糖异常的孕妇,母婴并发症的发生率更高,应加强对此类孕妇预防保健,减少母婴并发症.     

餐后血糖对2型糖尿病诊断的意义

目的通过口服葡萄糖耐量（OGTT）和胰岛素释放（IRT）试验,解析空腹和餐后血糖对糖尿病诊断的意义。方法收集2005年1月—2007年6月,内分泌和代谢科门诊及住院患者共3 588例进行OGTT和IRT检测。以血浆葡萄糖5.6、6.1、7.0mmol/L为空腹血糖切点,7.8、11.1mmol/L为餐后血糖切点,分析患者分布情况以及空腹血糖（FPG）、餐后1h血糖（1 h PG）和餐后2 h血糖（2 h PG）等不同切点对糖尿病诊断的价值。结果依据1999年WHO糖尿病诊断标准,诊断糖尿病患者3097例。其中FPG≥7.0mmol/L者2654例,单独检测2hPG漏诊62例,占2.33%;单独检测1hPG仅漏诊18例,占0.68%,差别有统计学意义（P〈0.001）。2 h PG≥11.1 mmol/L者中FPG〈7.0 mmol/L的占14.60%（443/3 035）;1 h PG≥11.1mmol/L者中FPG〈7.0mmol/L的占14.00%（429/3065）,差别无有统计学意义（P=0.503）。FPG和餐后2hPG均正常202例〔但其中113例存在高胰岛素血症和（或）胰岛素分泌延迟,占55.94%〕,其余289例为糖耐量受损和（或）空腹血糖受损。在1 hPG≥11.1 mmol/L且2 h PG〈11.1 mmol/L的291例中,54例FPG≥7.0mmol/L经复查诊断为糖尿病,另有125例餐后30 min血糖≥11.1 mmol/L者的HOMA指数及胰岛素曲线下面积与FPG5.6～6.1mmol/L而2 h PG≥11.1mmol/L的糖尿病患者接近。结论1 h PG与FPG的一致性不比2 h PG差,且更敏感,提示1 h PG同2 h PG一样,可以作为糖尿病的餐后血糖诊断切点。     

妊娠期糖尿病孕妇口服75g葡萄糖耐量试验不同时点血糖异常对新生儿并发症及神经行为发育的影响

目的分析妊娠期糖尿病(gestational diabetes mellitus,GDM)孕妇75g葡萄糖耐量试验(oral glucose tolerance test,OGTT)不同时点血糖异常对新生儿并发症及神经行为发育的影响。方法选取2015年10月至2016年4月在华北理工大学附属医院规律产检并住院分娩的GDM孕妇所生144例新生儿作为研究对象,其中孕妇75g OGTT 1项时点血糖异常为GDMⅠ组、2项时点血糖异常为GDMⅡ组、3项时点血糖均异常为GDMⅢ组;分别对3组孕妇的新生儿进行新生儿行为神经测定(neonatal behavioral neurological assessment,NABA)评分。结果①3组NABA评分相比较,GDMⅢ组低于GDMⅡ组和GDMⅠ组,且两两比较差异有统计学意义(P0.05)。②3组新生儿低血糖的发生率分别为5.2%、6.2%、23.0%;巨大儿的发生率分别为5.2%、18.7%、33.3%,组间比较差异均有统计学意义(P0.05)。③3组中,新生儿低血糖者NABA低于血糖正常者;巨大儿NABA评分低于非巨大儿。结论 75g OGTT异常时点越多,新生儿神经行为发育损伤及新生儿低血糖、巨大儿的发生率也越高。因此对不同层次的高危孕妇及新生儿应尽早采取不同的措施以改善不良预后。     

Diabetes and Hypertension in Urban Bhutanese Men and Women

Background:

Bhutan is a mountainous country with 31% urban population. There is no information on prevalence of diabetes and hypertension in Bhutan yet. This was the first study of its kind conducted in the capital city.

Objective:

To determine prevalence of diabetes, impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and hypertension in urban Bhutanese population aged 25 to 74 years.

Materials and Methods:

Stratified two-stage sampling was adopted to include 2474 respondents (Males: 1132, Females: 1342) equally distributed among different age and sex groups. A questionnaire containing demographic, educational and social details and history of diabetes and hypertension was administered on the sampled population the previous evening and blood pressure measured the next morning in nearby camp where fasting blood samples were collected and an oral glucose tolerance test done.

Results:

Age and sex standardized prevalence of diabetes, IGT and IFG were 8.2.0, 21.6 and 4%, respectively. Only 66.5% of the population had normal blood sugar. Prevalence of diabetes and IGT increased progressively with increasing age. Prevalence of hypertension was 26% (Males: 28.3%, Females: 23.2%). It was observed that 54.1% of diabetes population had hypertension.

Conclusion:

The study shows that not only is prevalence of diabetes and hypertension high in the urban Bhutanese but also there is a high diagnosis and treatment gap in these disorders.     

Effect of fructose or sucrose feeding with different levels on oral glucose tolerance test in normal and type 2 diabetic rats

This study was designed to determine whether acute fructose or sucrose administration at different levels (0.05 g/kg, 0.1 g/kg or 0.4 g/kg body weight) might affect oral glucose tolerance test (OGTT) in normal and type 2 diabetic rats. In OGTT, there were no significant differences in glucose responses between acute fructose- and sucrose-administered groups. However, in normal rats, the AUCs of the blood glucose response for the fructose-administered groups tended to be lower than those of the control and sucrose-administered groups. The AUCs of the lower levels fructoseor sucrose-administered groups tended to be smaller than those of higher levels fructose- or sucrose-administered groups. In type 2 diabetic rats, only the AUC of the lowest level of fructose-administered (0.05 g/kg body weight) group was slightly smaller than that of the control group. The AUCs of fructose-administered groups tended to be smaller than those of the sucrose-administered groups, and the AUCs of lower levels fructose-administered groups tended to be smaller than those fed higher levels of fructose. We concluded from this experiment that fructose has tendency to be more effective in blood glucose regulation than sucrose, and moreover, that smaller amount of fructose is preferred to larger amount. Specifically, our experiments indicated that the fructose level of 0.05 g/kg body weight as dietary supplement was the most effective amount for blood glucose regulation from the pool of 0.05 g/kg, 0.1 g/kg and 0.4 g/kg body weights. Therefore, our results suggest the use of fructose as the substitute sweetener for sucrose, which may be beneficial for blood glucose regulation.     

Plasma Transthyretin Levels and Risk of Type 2 Diabetes Mellitus and Impaired Glucose Regulation in a Chinese Population

Plasma transthyretin may be engaged in glucose regulation. We aimed to investigate the association between plasma transthyretin levels and the risk of newly diagnosed T2DM and impaired glucose regulation (IGR) in a Chinese population. We conducted a case-control study including 1244 newly diagnosed T2DM patients, 837 newly diagnosed IGR patients, and 1244 individuals with normal glucose tolerance (NGT) matched by sex and age. Multivariate logistic regression analysis was utilized to estimate the independent association of plasma transthyretin concentrations with the risk of T2DM and IGR. Plasma transthyretin concentrations were significantly higher in T2DM and IGR patients compared with control subjects (p < 0.005). After multiple adjustment and comparison with the lowest quartile of plasma transthyretin concentrations, the odds ratios (95% confidence intervals) of T2DM and IGR in the highest quartile were 2.22 (1.66, 2.98) and 2.29 (1.72, 3.05), respectively. Plasma transthyretin concentrations also showed a great performance in predicting the risk of T2DM (AUC: 0.76). Moreover, a potential nonlinear trend was observed. Our results demonstrated that higher plasma transthyretin concentrations, especially more than 290 mg/L, were associated with an increased risk of T2DM and IGR. Further studies are warranted to confirm our findings and elucidate the potential mechanisms.     

中国成人糖尿病患者口腔卫生保健行为状况

目的 了解中国≥18岁糖尿病患者口腔保健行为,为国家制定口腔健康教育政策提供依据。方法 资料来源于2010年中国慢性病及其危险因素调查数据,对其中10 473名糖尿病患者的口腔卫生行为进行分析。结果 11.9%的糖尿病患者在1年内看过牙医,33.7%的患者在5年内看过牙医,46.3%的患者从未看过牙医;2.3%的患者在1年内洗过牙,7.3%的患者在5年内洗过牙,87.6%的患者从来没有洗过牙;33.1%的患者能够做到每天早晚2次刷牙,87.4%的患者能够做到每天刷牙（至少每天1次）;女性患者1年口腔就医比例、5年口腔就医比例均高于男性,男性5年内洗牙比例高于女性（P<0.01）,刷牙情况性别差异无统计学意义;城市患者各项口腔行为指标均好于农村患者（P<0.01）;东部地区5年口腔就医比例、早晚刷牙率和每天刷牙比例均明显高于中西部地区（P<0.01）,洗牙情况地区差异无统计学意义;口腔就医行为、洗牙行为随年龄增长呈上升趋势,早晚刷牙比例、每天刷牙比例呈下降趋势（P<0.01）。结论 中国糖尿病患者口腔就医、洁治、刷牙等口腔卫生保健行为均较差,急需对糖尿病患者开展有效的口腔健康教育。     

阿卡波糖在合并糖代谢异常的心血管疾病患者中的早期应用效果观察

目的探讨心内科疾病的血糖如何检测,以及阿卡波糖在合并糖代谢异常的心血管疾病患者中的早期应用效果。方法收集近1年来本院心内科收住院的心血管疾病患者100例,住院期间行OGTT试验及糖化血红蛋白（HbA1c）检测（其中急性心肌梗死患者于急性期过后检测）,对所有糖代谢异常患者行阿卡波糖干预,3月后复查空腹血糖（FBG）和糖化血红蛋白（HbA1c）,前后比较有无差异性。结果OGTT共发现61例糖代谢异常患者,高血压组糖代谢异常为20例（50％）,稳定性心绞痛为19例（63．3％）,急性心肌梗死为22例（73．3％）,而FBG检测只发现25例,各组合并糖代谢畀常的患者．服用阿卡波糖后的FBG和HbA1c均有降低（P〈0．05）。结论对住院的高血压、冠心病患者,单纯行FBG监测会造成大量糖代谢异常患者漏诊,而常规0GTT试验有助于早期筛查和及时干预。阿卡波糖不仅有效控制餐后血糖,对控制I-IbAlc和FBG也有积极作用。     

克拉玛依人群糖耐量低减和2型糖尿病发病的危险因素

目的探讨与克拉玛依人群糖耐量低减 (IGT)和 2型糖尿病发病有关的危险因素。方法对克拉玛依市参加过1994～ 1995年全国糖尿病普查的 2 0 8例曾进行饮食问卷者进行饮食和临床分析 (其中正常糖耐量 87例 ,IGT5 4例 ,新诊断糖尿病 6 7例。)结果 IGT组和新诊断糖尿病组饮食总热量 ,蛋白质 ,脂肪 ,饱和脂肪酸、单不饱和脂肪酸、多不饱和脂肪酸摄入 ;以及体质指数 (BMI)、血空腹胰岛素和甘油三酯水平均明显高于正常组 (P分别 <0 .0 5和 <0 .0 1)。 L ogistic逐步回归分析显示 BMI和脂肪摄入与 IGT、糖尿病发病显著正相关 (P<0 .0 1)。结论肥胖、高脂肪饮食是克拉玛依人群IGT和 2型糖尿病发病的危险因素。合理的膳食和运动、很好的控制体重对预防 IGT和 2型糖尿病发病十分重要     

2型糖尿病血糖水平与胰岛素释放关系的研究

目的为探讨2型糖尿病血糖与胰岛素释放的关系,我们研究了不同血糖水平对胰岛β细胞释放胰岛素的影响.方法 98例2型糖尿病患者停用口服降糖药48h后做口服75g葡萄糖耐量试验(OGTT)及胰岛素释放试验(IRT),对血糖和胰岛素结果进行相关分析,同时评价空腹和口服葡萄糖后血糖的高低、峰值血糖的时相、血糖峰基比等对基础和糖刺激后胰岛素释放的影响.结果 OGTT血糖水平与基础有的是无明显相关,与刺激后胰岛素水平呈明显负相关,尤其是与峰值胰岛素(Imax)和胰岛素峰基比(M/B1)呈负相关;基础血糖大于11.1mol/L的Imax和M/B1大约是基础血糖小于11.1mol/L的三分之一(P＜0.01),峰值血糖大于16.7mol/L的Imax和M/B1也明显胝于峰值血糖较小者(P＜0.01～0.05);峰值血糖时相越延迟,Imax和M/B1就越低;血糖峰基比大于2者的Imax和M/B1高于较小者(P＜0.01).结论 2型糖尿病的高血糖(基础或糖负荷后血糖)对葡萄糖刺激的胰岛素释放水平具有明显的损害作用,对基础胰岛素水平影响不大.