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作者：Laurie Barclay, MD  
出處：WebMD醫學新聞
　　November 29, 2009 — 根據一項發表於11月16日糖尿病照護期刊的研究結果，沒有顯著糖尿病的患者，如果一小時血糖上升，可能是心血管風險的指標。
　　
　　糖尿病前期（pre-diabetes；pre-DM）確認空腹血糖過高（IFG）以及/或是葡萄糖耐受性不佳（IGT）個體發生第二型糖尿病（T2DM）風險較高；義大利佛羅倫斯大學Gianluca Bardini醫師與其同事們寫到，除此之外，這與胰島素抗性（IR）有關、也和亞臨床發炎反應與心血管疾病（CVD）有關。最近，葡萄糖耐受性檢測（OGTT）以155 mg/dl作為閾值的一小時高血糖（1hPG）被認為是T2DM進一步的危險因子，且顯示出初期頸動脈粥狀動脈硬化。
　　
　　這項研究的目的在於評估1,062位正常糖尿病耐受性與糖尿病前期受試者的代謝特徵與發炎指標。比較投予葡萄糖一小時後血糖值超過155 mg/dl或低於該數值受試者的纖維蛋白原與白血球數目作為亞臨床發炎的指標、血脂肪比值、以及以Matsuda指標評估胰島素敏感性。
　　
　　相較於血糖值低於155 mg/dl的受試者，那些一小時後高於155 mg/dl的受試者，發炎指標與血脂肪比值顯著增加（所有比較的P值都<0.05）。校正年齡、性別與身體質量指數的分析後，血糖數值顯著地與血球數目及纖維蛋白增加有關（P<0.05）。相較於一小時後血糖低於155 mg/dl的受試者，那些血糖值高於155 mg/dl的受試者，胰島素敏感度顯著較低（P<0.1）。
　　
　　研究作者們寫到，NGT（正常葡萄糖耐受性）與糖尿病前期患者1hPG上升和亞臨床發炎、高血脂肪比值及胰島素耐受性變差有關。因此，1hPG>155 mg/dl可以被認為是一個新的心血管危險因子標記。
　　
　　研究作者們表示已無相關資金上的往來。


One-hour Plasma Glucose More Than 155 mg/dL May Be Marker for Cardiovascular Risk
By Laurie Barclay, MD
Medscape Medical News
November 29, 2009 — Elevated 1-hour plasma glucose level in persons without overt diabetes may be a marker for cardiovascular risk, according to the results of a study reported ahead of print in the November 16 issue of Diabetes Care.
"Pre-diabetes (pre-DM) identifies subjects with impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT) at high risk for type 2 diabetes (DM2); moreover, it is associated to insulin resistance (IR), subclinical inflammation and cardiovascular diseases (CVD)," write Gianluca Bardini, MD, PhD, from the University of Florence in Florence, Italy, and colleagues. "Recently, 1-hour hyperglycaemia (1hPG) during glucose tolerance test (OGTT) with a cut point of 155 mg/dl has been indicated as a further risk factor for DM2 and showed early carotid atherosclerosis."
The goal of the study was to evaluate metabolic characteristics and markers of inflammation in 1062 subjects with normal glucose tolerance and prediabetes. Fibrinogen and leukocyte count for subclinical inflammation, lipid ratios, and insulin sensitivity measured with the Matsuda Index were compared in subjects with vs without a 1-hour plasma glucose level of more than 155 mg/dL after oral glucose loading.
Compared with subjects with a 1-hour plasma glucose level of 155 mg/dL or less, those with 1-hour plasma glucose levels of more than 155 mg/dL had significantly increased inflammatory markers and lipid ratios (P < .05 for all comparisons). An analysis adjusted for age, sex, and body mass index showed that 1-hour plasma glucose level was associated with significantly increased white blood cell count and fibrinogen (P < .05). Compared with subjects with 1-hour plasma glucose levels of 155 mg/dL or less, those with 1-hour plasma glucose levels of more than 155 mg/dL had significantly lower insulin sensitivity (P < .01).
"Elevated 1hPG in NGT [normal glucose tolerance] and pre-DM subjects is associated to subclinical inflammation, high lipid ratios and insulin resistance," the study authors write. "Therefore, 1hPG >155 mg/dl could be considered a new 'marker' for cardiovascular risk."
The study authors have disclosed no relevant financial relationships.
Diabetes Care. Published online November 16, 2009.