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1.
目的探讨糖尿病前期人群经综合治疗1年后糖代谢的转归情况。方法选取2015年2月至2016年1月山东省青岛疗养院住院及健康查体的糖尿病前期患者189例,将研究对象分为空腹血糖受损(IFG)组、糖耐量异常(IGT)组和IFG+IGT组。经综合干预1年后调查研究对象糖代谢转归情况。结果随访1年糖尿病前期人群2型糖尿病(T2DM)发病率为12.70%,其中IFG组、IGT组、IFG+IGT组的T2DM年发病率分别为6.35%、13.00%、18.18%。糖尿病前期转归为正常糖代谢(NGT)年发生率为11.64%,其中IFG组、IGT组、IFG+IGT组转归为NGT年发生率为17.46%、11.67%、6.06%。结论本研究采用综合干预方式,IFG组与IGT组向NGT及T2DM转归无差异,而IFG+IGT组向糖尿病发展的概率更高,较IFG更应早期综合干预。  相似文献   

2.
目的探讨氯氮平与氯丙嗪对男性首发精神分裂症患者空腹血糖的影响。方法将35例长期单一口服氯氮平治疗的男性首发精神分裂症患者设为氯氮平组,68例长期单一口服氯丙嗪治疗的男性首发精神分裂症患者设为氯丙嗪组,观察1a。于治疗前及治疗1a末检测两组空腹血糖。结果治疗1a末,两组空腹血糖水平均较治疗前显著升高(P〈0.05或0.01);氯氮平组空腹血糖水平高于正常值检出率为34.29%,氯丙嗪组为14.71%,氯氮平组显著高于氯丙嗪组(χ^2=5.27,P〈0.05)。结论氯氮平与氯丙嗪对精神分裂症患者的糖代谢均有显著影响,氯氮平影响更为显著,临床医生对长期服用氯氮平、氯丙嗪治疗的精神分裂症患者应定期检测血糖。  相似文献   

3.
目的 通过二甲双胍对精神分裂症患者糖尿病前期的早期干预,延缓或降低抗精神病药治疗中糖尿病的发生.方法 首发未使用抗精神病药物的精神分裂症患者65例,按糖调节受损的程度分为空腹血糖受损(IFG)和糖耐量受损(IGT)两大组,随机将IFG组和IGT组分为实验组和对照组.对IFG和IGT实验组患者进行小剂量二甲双胍治疗,治疗前后分别测量血糖、血脂、血压、体重指数、糖化血红蛋白,对结果 进行统计分析.结果 二甲双胍对精神分裂症患者糖尿病前期的早期干预可以降低抗精神病药治疗中糖尿病发生的风险.  相似文献   

4.
目的 通过二甲双胍对精神分裂症患者糖尿病前期的早期干预,延缓或降低抗精神病药治疗中糖尿病的发生.方法 首发未使用抗精神病药物的精神分裂症患者65例,按糖调节受损的程度分为空腹血糖受损(IFG)和糖耐量受损(IGT)两大组,随机将IFG组和IGT组分为实验组和对照组.对IFG和IGT实验组患者进行小剂量二甲双胍治疗,治疗前后分别测量血糖、血脂、血压、体重指数、糖化血红蛋白,对结果 进行统计分析.结果 二甲双胍对精神分裂症患者糖尿病前期的早期干预可以降低抗精神病药治疗中糖尿病发生的风险.  相似文献   

5.
目的 通过二甲双胍对精神分裂症患者糖尿病前期的早期干预,延缓或降低抗精神病药治疗中糖尿病的发生.方法 首发未使用抗精神病药物的精神分裂症患者65例,按糖调节受损的程度分为空腹血糖受损(IFG)和糖耐量受损(IGT)两大组,随机将IFG组和IGT组分为实验组和对照组.对IFG和IGT实验组患者进行小剂量二甲双胍治疗,治疗前后分别测量血糖、血脂、血压、体重指数、糖化血红蛋白,对结果 进行统计分析.结果 二甲双胍对精神分裂症患者糖尿病前期的早期干预可以降低抗精神病药治疗中糖尿病发生的风险.  相似文献   

6.
滕香宇  刘伟  贾芸 《临床荟萃》2004,19(13):730-732
目的 探讨腹型肥胖人群中不同糖代谢水平者胰岛素抵抗及胰岛分泌功能的状态。方法 腹型肥胖患者共382例,其中正常糖耐量(NGT)组251例,空腹血糖异常(IFG)组40例,异常糖耐量(IGT)组41例,2型糖尿病(DM组)50例。测腰围、血压、空腹血脂、血糖及血浆胰岛素,应用稳态模式胰岛素抵抗指数(HOMA-IR)作为胰岛素抵抗指标,稳态模式胰岛B细胞功能指数(HBCI)作为胰岛素分泌指标。结果 在腹型肥胖的人群中,不同糖代谢组的HOMA-IR差异具有统计学意义,从NGT→IFG/IGT→DM组HOMA-IR逐渐升高,而HBCI在各组内变化较大,数值分布较分散,与NGT、IFG、IGT组相比,DM组的HBCI明显下降,差别有统计学意义。同时收缩压随着糖代谢的恶化从NGT、IGT IFG到DM组逐步升高,舒张压的变化无明显的规律。结论 腹型肥胖人群中,从NGT经IFG/IGT向2型糖尿病发展的过程中,胰岛素敏感性逐渐下降,β细胞胰岛素分泌功能明显下降是出现DM的主要原因。这一结果与其他种族中的研究结果不完全相同,提示即使是肥胖相关的2型糖尿病,种族、遗传因素仍然在糖尿病发展过程中发挥着重要作用。  相似文献   

7.
目的通过二甲双胍对精神分裂症患者糖尿病前期的早期干预,延缓或降低抗精神病药治疗中糖尿病的发生。方法首发未使用抗精神病药物的精神分裂症患者65例,按糖调节受损的程度分为空腹血糖受损(IFG)和糖耐量受损(IGT)两大组,随机将IFG组和IGT组分为实验组和对照组。对IFG和IGT实验组患者进行小剂量二甲双胍治疗,治疗前后分别测量血糖、血脂、血压、体重指数、糖化血红蛋白,对结果进行统计分析。结果二甲双胍对精神分裂症患者糖尿病前期的早期干预可以降低抗精神病药治疗中糖尿病发生的风险。  相似文献   

8.
目的探讨血清脂联素、超敏C反应蛋白(hs-CRP)水平变化与糖尿病前期发生的危险因素的关系。方法选取健康对照组(NGT)、糖耐量减低组(IGT)、空腹血糖受损合并糖耐量减低组(IFG/IGT)各100例,测定各受试者血清脂联素、hs-CRP、空腹胰岛素、空腹血糖、餐后2 h血糖,应用稳态模型评估法评价胰岛素抵抗。结果 IGT组、IFG/IGT组血清脂联素均显著低于NGT组(P<0.01),IFG/IGT组的脂联素水平低于单纯IGT组(P<0.05)。脂联素水平与空腹血糖、餐后2 h血糖、胰岛素抵抗指数(HOMA-IR)呈负相关(P值均小于0.01)。单纯IGT组、IFG/IGT组血清hs-CRP水平明显高于NGT组(P<0.01),IFG/IGT组血清hs-CRP水平高于单纯IGT组(P<0.05)。血清hs-CRP水平与空腹血糖、餐后2 h血糖、HOMA-IR呈正相关(P值均小于0.01)。结论血清脂联素、hs-CRP可能是加重糖尿病前期胰岛素抵抗的危险因素,糖调节受损期即可能存在慢性低度炎症反应。在糖尿病前期,脂联素、hs-CRP可能参与了糖尿病的发生及发展。  相似文献   

9.
目的比较单纯冠心病(CHD)和冠心病合并三种不同类型糖代谢异常(空腹血糖调节受损IFG、糖耐量减低IGT、糖尿病DM)患者血浆B型钠尿肽(BNP)和血清超敏c反应蛋白(hs-CRP)水平的相关性。方法按冠心病及糖代谢异常诊断标准,将180例患者分为单纯冠心病组(CHD)、单纯糖代谢异常组、冠心病(CHD)合并空腹血糖调节受损(IFG)组、冠心病(CHD)合并糖耐量减低(IGT)组、冠心病(CHD)合并糖尿病(DM)组和正常对照组(无冠心病和糖代谢异常、6组,各组均30倒。采用免疫透射比浊法检测血清hs—CRY,免疫荧光快速测定法测定BNP值。结果单纯冠心病组(CHD)、单纯糖代谢异常组、CHD舍并IFG组、CHD合并IGT组、CHD合并DM组患者的hs—CRP和BNP浓度水平均高于正常对照组(P〈0.05),CHD合并IFG组、CHD合并IGT组、CHD合并DM组均高于单纯糖代谢异常组和单纯冠心病组(P〈0.05),CHD合并DM组高于CHD合并IFG组、CHD合并IGT组、单纯冠心病组、单纯糖代谢异常组(P〈0.05),CHD合并IFG和CHD合并IGT组,差异无统计学意义(P〉0.05)。结论冠心病合并各种糖代谢异常(IFG、IGT、DM)患者hs—CRP和BNP浓度水平均显著升高,其中,冠心病合并DM患者的hs—CRP和BNP浓度水平升高最显著。  相似文献   

10.
长沙市马王堆社区糖代谢异常的流行病学研究   总被引:1,自引:0,他引:1  
目的 :了解长沙市马王堆社区糖代谢异常 (abnormalglucosemetabolism ,AGM ) ,包括糖尿病 (DM )、糖耐量异常 (IGT)及空腹血糖异常 (IFG)的流行病学情况 ,分析其患病相关因素。方法 :采用横断面调查的方法对该社区 83 1人进行AGM的流行病学研究。结果 :( 1)AGM、DM、IGT、IFG患病率分别为 3 6 7%、9 5 %、14 8%、12 4%。此次调查新发现的DM占全部DM 78 5 % ,其中无症状者占 5 4 9%。IGT和IFG患病率女 >男。 ( 2 )DM、IGT组平均年龄大于糖代谢正常组。 70岁以前 ,DM患病率随年龄增加而增加 ,IGT患病率在 40岁以后逐步上升。 ( 3 )肥胖组AGM、DM和IGT患病率高于正常体重组 ,其AGM、DM患病率高于超重组 ;超重组IGT发生率高于正常体重组。DM、IGT组体重指数、腰围、臀围及腰臀比高于正常体重组 ,IFG组体重指数、腰围和腰臀比低于DM组。 ( 4 )DM、IGT组高血压患病率较IFG及糖代谢正常组高。DM、IGT组收缩压和舒张压高于IFG及糖代谢正常组。 ( 5 )有DM家族史者AGM的发生率与无家族史者无差异。 ( 6)多元逐步回归结果显示 :空腹血糖与腰臀比、年龄呈正相关 ,女性高于男性 ;餐后 2h血糖与年龄、腰臀比、体重指数呈正相关 ,数值女性高于男性 ,与家族史有关。结论 :长沙市马王堆社区AGM、DM、IGT、IFG的患病率分  相似文献   

11.
目的初步评价血糖调节受损患者血脂代谢异常情况。方法检测糖耐量正常(NGT)、单纯空腹血糖异常(IFG)、单纯糖耐量异常(IGT)、空腹血糖异常合并糖耐量异常(IFG IGT)和糖尿病(DM)患者空腹血糖和餐后2 h血糖及空腹血清总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A-I(apo A-I)和载脂蛋白B(apo B)水平,计算非高密度脂蛋白胆固醇(non-HDL-C)和血浆致动脉硬化指数(AIP),比较各组间血清脂质成分的差异。结果IFG组血清TC、LDL-C、non-HDL-C和apo B水平较NGT组明显升高(P<0.01),而TG、HDL-C、AIP差异无统计学意义(P>0.05)。IGT组血清TC、TG、LDL-C、non-HDL-C、apo A-I、apo B和AIP水平较NGT组显著升高(P<0.01),前6项指标与IFG IGT组差异无统计学意义(P>0.05)。IFG IGT组与NGT组比较,各指标差异均有统计学意义(P<0.01);HDL-C、non-HDL-C和AIP水平与IFG组比较差异有统计学意义(P<0.01)。DM组表现出典型的DM性脂代谢紊乱伴AIP水平显著异常。non-HDL-C和apo B间存在良好的相关性(P<0.01)。结论血糖调节受损者不同程度的存在血脂代谢异常,主要表现为TC、TG、LDL-C、non-HDL-C和apo B水平的升高和HDL-C、apo A-I的降低,伴不同程度AIP水平的改变。  相似文献   

12.
Background Although several lines of evidence suggest that hypomagnesaemia is a risk factor for developing type 2 diabetes, there are no studies regarding the association between hypomagnesaemia and the risk for developing impaired fasting glucose (IFG) or impaired glucose tolerance (IGT). Our objective was to examine the association between serum magnesium levels and the risk for developing IFG, IGT and type 2 diabetes. Materials and methods A total of 1122 individuals (20–65 years of age) were enrolled between 1996 and 1997, and 817 individuals re‐examined about 10 years later. New‐onset IFG (5·6–7·0 mmol L?1 fasting glucose), IGT (7·8–11·1 mmol L?1 glucose 2‐h postload), and type 2 diabetes were determined from the number of subjects who had these conditions at the second examination without evidence that they were present at the first one. The relative risk of new‐onset metabolic glucose disorders and diabetes (dependent variables) was computed using Poisson regression model adjusted for age, sex, family history of diabetes, waist circumference and homeostasis model assessment for insulin resistance index. Serum magnesium levels of < 0·74 mmol L?1 (independent variable) defined the exposed group. Results At baseline, 420 (51·4%) individuals had hypomagnesaemia. New‐onset IFG and IGT was identified in 276 (33·8%) individuals. The relative risk for IFG, IGT and IFG + IGT was 1·11 (95% confidence interval, 0·5–5·1), 1·38 (95% confidence interval, 1·1–6·3) and 1·49 (95% confidence interval, 1·1–4·9), respectively. New‐onset diabetes was identified in 78 (9·5%) individuals (relative risk 2·54; 95% confidence interval, 1·1–4·1). Conclusions Hypomagnesaemia is independently associated with the development of IGT, IFG + IGT and type 2 diabetes, but not with the development of IFG.  相似文献   

13.
We sought to clarify whether impaired fasting glucose (IFG), impaired glucose tolerance (IGT) or both (IFG/IGT) represent the most severe impairment in insulin resistance (IR) and insulin secretion. Among the 159 Chinese subjects, 21 were diagnosed as having IFG, 103 as having IGT and 35 as having both. IR and beta-cell function were assessed using homeostatic model assessment (HOMA) and an insulin-suppression test (IST). No differences were evident between the groups in blood pressure, body mass index, plasma insulin fasting levels and lipid profiles. However, plasma 2-h insulin levels were higher in the IGT and IFG/IGT groups. Beta-cell functions were not different between these groups. But, the result of glucose tolerance was different, in which the IFG/IGT and IFG groups displayed higher insulin sensitivity than IGT via HOMA instead of no difference via IST in the three patient groups.  相似文献   

14.

Objective

Within the frame of a randomized clinical trial to examine whether training of general practitioners (the intervention group) in intensive lifestyle modification and pharmacological treatment of patients with type 2 diabetes has a spillover effect on individuals with impaired fasting glycaemia (IFG) or impaired glucose tolerance (IGT).

Design

A high-risk screening study for type 2 diabetes with an intervention programme, where general practices were randomized to provide standard treatment versus intensive lifestyle modification and pharmacological treatment to newly diagnosed diabetic patients.

Setting

General practices in Denmark.

Subjects

Of 1821 individuals identified with IFG or IGT, results from oral glucose tolerance tests after one and three years were available in 1510 individuals.

Main outcome measures

Progression rates from IFG and IGT to diabetes and effect of intervention were estimated in a regression model using interval censoring.

Results

A total of 442 persons developed diabetes. There was no significant overall effect of intervention on progression rates. For risk factors, no difference in rate of change was found between randomization groups, but a difference was found between general practices within the same randomization groups.

Conclusion

General practitioners identify a high number of incident diabetes cases in individuals with IFG or IGT found by high-risk screening. Intervention at the general practitioner''s level in intensive treatment type 2 diabetes does not have a significant spillover effect reducing the risk of diabetes from pre-diabetic conditions. This could indicate that intervention strategies should be specifically targeted at individuals with IFG or IGT, either by training general practitioners or directly at the individual level.  相似文献   

15.
目的分析2003年美国糖尿病学会(ADA)空腹血糖受损(IFG)的空腹血糖(FPG)诊断标准下调对中老年糖调节受45(IGR)人群检出率的影响,并探讨区分糖调节正常与受损的FPG理想切点。方法3219例50岁以上台州农村人群分层整群随机抽样调查,空腹测毛细血管血糖。若FPG5.6mmol/L做OGTF检查。结果IFG患病率按新诊断切点5.6mmol/L为10.15%,按原切点6.1mmol/L为1.24%,两组比较,差异有统计学意义(X^2=83.55,P〈0.05);空腹血糖受损合并糖耐量受损(IGT)患病率按新诊断切点5.6mmol/L为6.14%.按原切点6.1mmol/L为3.26%,两组比较,差异有统计学意义(X^2=10.78,P〈0.05)。计算不同FPG切点诊断IGR的约登指数,最大值对应的FPG为5.7mmol/l。结论IFG诊断标准下调后,IFG、IFG+IGT检出率明显增加:非DM中老年人群中诊断IGR的FPG理想截定点为5.7mmol/L.  相似文献   

16.
Background Few European studies have used an oral glucose tolerance test (OGTT) to examine the incidence of type 2 diabetes. We determined the incidence of impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and type 2 diabetes in a population from southern Spain. Material and methods A population‐based cohort study was undertaken in Pizarra, Spain. Baseline data were recorded on age, sex, weight, height, waist and hip circumferences, and diabetes status for 1051 persons, of whom 910 were free of type 2 diabetes (at‐risk sample). Of these, 714 completed the 6‐year follow‐up study. Body mass index, waist‐to‐hip ratio and weight increase since baseline were calculated. The homeostasis model assessment equations were used to estimate the indices of insulin resistance and β‐cell function. Each person received an OGTT at baseline and after 6 years. Results Type 2 diabetes developed in 81 people for a total of 4253 person‐years, representing an incidence of 19·1 cases per 1000 person‐years (95% confidence interval, 15·3–23·6). Age and the presence of obesity, central obesity and carbohydrate metabolism disorders [IFG (cut off = 100 mg dL?1, capillary blood glucose level), IGT or both] at baseline were significant markers for the onset of type 2 diabetes during follow‐up. After adjusting for these variables, multivariate analysis showed weight increase, waist‐to‐hip ratio and the indices of insulin resistance and β‐cell function were significantly associated with the risk for type 2 diabetes. Conclusions The incidence of type 2 diabetes in a population from southern Spain is high. It is probably associated with the high prevalence of obesity and weight increase in this population.  相似文献   

17.
目的比较空腹血糖(FPG)和糖化血红蛋白(HbAlc)在筛查糖耐量减退(IGT)中的应用价值。方法到我院门诊为明确有无血糖异常而就诊者336人,测定空腹血糖、糖化血红蛋白,并行口服葡萄糖耐量试验(OGTT)。结果按照1999年WHO的DM诊断标准,本研究人群空腹血糖〈6.1者124例,≥6.1-〈7.0者56例,≥7.0者156例;糖化血红蛋白〈6.1者84例,≥6.1者252例;OGTT2 hPG〈7.8者92例,≥7.8-〈11.1者99例,≥11.1者145例。结论糖化血红蛋白和空腹血糖均不适用于筛查IGT人群,但糖化血红蛋白比空腹血糖提示病人是否存在血糖异常更敏感。  相似文献   

18.
目的研究胰岛素抵抗和胰岛β细胞功能与中国人血糖调节异常(IGR)的关系。方法根据口服葡萄糖耐量试验(OGTT)将209例受试者分为正常糖耐量(NGT)组、空腹血糖受损(IFG)组、糖耐量减退(IGT)组、IFG/IGT组和糖尿病(DM)患者组,用胰岛素敏感指数(ISI-COM)评价胰岛素抵抗(IR),用调整β细胞功能指数(modifiedβcell function index,MBCI)评价β细胞功能,并用早期胰岛分泌指数(△I30/△G30)评价急性期胰岛分泌功能,OGTT胰岛素曲线下面积评价二相期胰岛素分泌功能。结果IGR各组与DM组ISI-COM较NGT组有显著降低,差异有统计学意义(P0.01),而IGR各组间差异无统计学意义(P0.05)。IFG组和IGT组β细胞功能较NGT组显著降低,差异有统计学意义(P0.01),而IFG/IGT组与DM组间差异无统计学意义(P0.05)。各病例组早期胰岛分泌功能亦较NGT组有显著性降低,差异有统计学意义(P0.01),IGT组与IFG组间差异也有统计学意义(P0.01)。结论IGR各阶段均存在不同程度的IR和β细胞功能异常,其中IFG和IGT有不同的发病机制和过程,提示对于不同糖代谢异常的患者需要不同的治疗方式,以延缓血糖代谢异常的进展。  相似文献   

19.
Purpose: The purposes of this observational prospective study were (a) to identify the prevalence of undiagnosed impaired glucose metabolism (IGM) including impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and type 2 diabetes mellitus (T2DM) in 55 Hispanic subjects with two or more risk factors for the metabolic syndrome, (b) to examine the association between glucose metabolism and cardiometabolic risk factors (CMRF), including metabolic syndrome components, and (c) to identify predictors of IGM.
Data sources: Subjects underwent a physical examination and a 2-h 75-g oral glucose tolerance test. Data were analyzed using SAS v9.1 with p ≤ .05 considered significant. Nonparametric tests were applied including Mann–Whitney–Wilcoxon test and Spearman correlation coefficient. Stepwise logistic multiple regression was used to predict IGM.
Conclusions: Twenty-five patients (46%) had IGM (18% IFG, 15% IGT, and 13%T2DM). Normal fasting glucose was found in 48% of subjects who had IGM. Lipid abnormalities were present in 98% including elevated triglycerides (TG 66%), total cholesterol (48%), low-density lipoprotein (68.8%), and low high-density lipoprotein (67.9%). Twenty-nine percent had body mass index (BMI) >25 kg/m2 and 62% had BMI >30 kg/m, hypertension (24%), and elevated high-sensitivity C-reactive protein (63%), and mean number of cardiometabolic risk factors (#CMRF) was 4.5. Mean values for each risk factor were no different between groups except for #CMRF ( p = .0001) and TG ( p = .0001). Total #CMRF was the best predictor of IGM.
Implications for Practice: The prevalence of IGM is extremely high in Hispanics with metabolic syndrome. Screening for IGM with fasting blood glucose alone underestimates the prevalence of IGM in this population. In subjects with multiple CMRF, screening at lower levels of BMI is warranted.  相似文献   

20.
Objective: Diabetes mellitus is associated with endothelial dysfunction and oxidative stress (OS). The aim of the present study was to determine whether increased OS and impaired endothelial function, are present in early states of diabetes, such as impaired glucose tolerance (IGT) and impaired fasting glucose (IFG). Methods: Brachial artery flow‐mediated dilatation (FMD) and nitrate‐induced dilatation were measured in 133 subjects with carbohydrate abnormalities (45 IGT, 44 IFG and 44 Type 2 diabetes mellitus) and in 46 subjects with normal glucose tolerance (NGT). Waist circumference, body mass index, blood pressure and fasting lipid profiles were obtained, and glucose and insulin values in response to a 75‐g oral glucose load were also measured. Plasma malondialdehyde (MDA) and superoxide dismutase (SOD) activity were determined. Results: Patients with diabetes and prediabetes had a higher plasma MDA concentration, but a lower plasma SOD activity than the NGT group (p = 0.006) and SOD activity was positively associated with FMD (p = 0.039). FMD were significantly reduced in the groups of subjects with abnormal carbohydrate metabolism compared with the NGT group (p = 0.035). Among the subjects with diabetes and prediabetes, FMD showed a negative correlation with fasting glucose and/or plasma glucose level at 120 min after oral glucose tolerance test (p = 0.028). Conclusions: The results showed that endothelial dysfunction and increased OS were present in subjects with IGT and IFG, indicating endothelial damage in these stages.  相似文献   

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