在SHiDS研究中,对中级高血糖和糖尿病的ADA和IDF诊断标准进行比较
Yinan Zhang1, Shuang Liu2, Baige Cao2
1Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, The Metabolic Disease Biobank, Shanghai, China.
Diabetes research and clinical practice
|December 20, 2024
概括
对糖尿病和葡萄糖代谢受损的诊断标准进行比较,发现了差异. 美国糖尿病协会 (ADA) 和国际糖尿病联合会 (IDF) 的指导方针确定了不同的胰岛素抵抗和β细胞功能障碍的个体.
科学领域:
- 内分泌学 在内分泌学.
- 代谢障碍 代谢障碍 代谢障碍
- 糖尿病研究 糖尿病研究
背景情况:
- 美国糖尿病协会 (ADA) 和国际糖尿病联合会 (IDF) 为诊断糖尿病和葡萄糖代谢受损提供了不同的指导方针.
- 诊断标准的差异可能导致血糖状况的不同分类,影响患者管理和流行病学研究.
研究的目的:
- 使用ADA和IDF标准,比较糖尿病和葡萄糖代谢受损 (IH) 的患病率.
- 为了评估胰岛素分泌,胰岛素敏感性和口服葡萄糖耐受性测试 (OGTT) 曲线模式,在不同的葡萄糖耐受性类别.
- 评估ADA和IDF指南之间的诊断不一致性及其临床影响.
主要方法:
- 利用了上海高风险糖尿病查 (SHiDS) 研究中5,387名成年参与者的数据.
- 对所有参与者进行了五点,75克口服葡萄糖耐受性测试 (OGTT).
- 使用ADA/IDF标准对血糖指数进行分类,并通过OGTT衍生指数评估胰岛素分泌/敏感性.
主要成果:
- 根据ADA和IDF标准,在3729名受试者中观察到一致的诊断.
- 在941名糖尿病患者和717名IH诊断患者中发现了显著的不一致性.
- 与正常葡萄糖耐受 (NGT) 组相比,患有不一致诊断的个体表现出β细胞功能障碍和/或胰岛素耐药性.
结论:
- 根据ADA的标准,即使在血葡萄糖水平正常的1小时内,也可以发现HbA1c升高的个体.
- 当禁食血葡萄糖,2小时血葡萄糖和HbA1c正常时,IDF标准检测出胰岛素敏感性和分泌的受损.
- 这些差异突显出需要考虑ADA和IDF标准,以全面评估葡萄糖代谢和糖尿病风险.
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