作为2型糖尿病 (T2D) 的预测因素,比较胰岛素抵抗的代孕指数
Laura Vazquez1, Elsa Vazquez Arreola1, Murugasu Nagul1
1Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health; 445 N 5th St, Suite 210, Phoenix, AZ 85004, United States.
The Journal of clinical endocrinology and metabolism
|March 10, 2026
概括
口服葡萄糖耐受性测试 (OGTTs) 提供了预测2型糖尿病 (T2D) 风险的最佳替代指数. 使用禁食胰岛素水平的指数表现优于没有胰岛素测量的指数,有助于T2D预防策略.
科学领域:
- 内分泌学 在内分泌学.
- 代谢疾病 代谢疾病
- 公共卫生 公共卫生
背景情况:
- 胰岛素抵抗是2型糖尿病 (T2D) 的关键风险因素.
- 使用标准临床试验准确预测T2D风险对于有效预防至关重要.
- 需要确定可靠的替代胰岛素敏感性指数.
研究的目的:
- 为了比较18个不同的胰岛素抵抗替代指数的预测性能.
- 评估哪些指数最能预测T2D的发展.
主要方法:
- 一项基于社区的,对美国西南部2260名土著美国人的纵向队列研究.
- 随访时间长达14.5年,确定了509例T2D.
- 通过使用相关系数 (r) 与高胰岛素-高血糖 (M) 和接收器运行曲线 (AUC) 下的面积进行了18个代理指数的比较.
主要成果:
- 来自口服葡萄糖耐受性测试 (OGTTs) 的指数显示出卓越的性能.
- 松田指数显示了与针测量胰岛素敏感性 (M) 的最高相关性 (r=0.691).
- 古特和塞德霍尔姆指数实现了最高的AUC (0.728),表现优于其他指数. 在基于禁食胰岛素的指数中,QUICKI和HOMA-IR表现最好 (AUC=0.701). 在不需要测量胰岛素的指数中,METS-IR显示了最高的AUC (0.688).
结论:
- 使用OGTT的替代措施对预测T2D风险最有效.
- 基于胰岛素的替代措施通常优于不需要胰岛素测量的替代措施.
- 这些发现可以为T2D风险评估和预防计划选择最佳指数提供信息.
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