The Oral Glucose Tolerance Test: 100 Years Later.
The Oral Glucose Tolerance Test: 100 Years Later.
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DOI：
10.2147/dmso.s246062
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发表时间：
2020
期刊：
影响因子：
--
通讯作者：
Bergman M
中科院分区：
文献类型：
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作者：
Jagannathan R;Neves JS;Dorcely B;Chung ST;Tamura K;Rhee M;Bergman M
100多年来，口服葡萄糖耐量试验（OGTT）一直是检测糖尿病前期和2型糖尿病（T2 DM）的基石。近几十年来，使用空腹血糖（FPG）、2小时负荷后血糖（2小时PG）和/或HbA 1c确定国际上可接受的临界点来定义中度高血糖症（前驱糖尿病）引起了争议。尽管如此，对于OGTT期间定义血糖异常状态的2-h PG已达成坚定的全球共识。本文综述了OGTT的发展历史及其应用的最新进展，包括葡萄糖负荷试验和确定葡萄糖曲线形状的数学模型。还考虑了FPG、OGTT期间2小时PG和HbA 1c的缺陷。最后，30分钟和1小时血糖（1小时PG）水平来自OGTT和糖尿病及其并发症的发病率之间的关联将进行审查。大量证据支持使用1 h PG来修改当前的筛查和诊断建议。当胰腺β细胞功能基本上更完整时，1 h PG水平的测量可以增加识别高风险个体的可能性，并具有潜在替代传统2 h OGTT的实际优势，使其在临床环境中更容易接受。
For over 100 years, the oral glucose tolerance test (OGTT) has been the cornerstone for detecting prediabetes and type 2 diabetes (T2DM). In recent decades, controversies have arisen identifying internationally acceptable cut points using fasting plasma glucose (FPG), 2-h post-load glucose (2-h PG), and/or HbA1c for defining intermediate hyperglycemia (prediabetes). Despite this, there has been a steadfast global consensus of the 2-h PG for defining dysglycemic states during the OGTT. This article reviews the history of the OGTT and recent advances in its application, including the glucose challenge test and mathematical modeling for determining the shape of the glucose curve. Pitfalls of the FPG, 2-h PG during the OGTT, and HbA1c are considered as well. Finally, the associations between the 30-minute and 1-hour plasma glucose (1-h PG) levels derived from the OGTT and incidence of diabetes and its complications will be reviewed. The considerable evidence base supports modifying current screening and diagnostic recommendations with the use of the 1‐h PG. Measurement of the 1‐h PG level could increase the likelihood of identifying high-risk individuals when the pancreatic ß-cell function is substantially more intact with the added practical advantage of potentially replacing the conventional 2‐h OGTT making it more acceptable in the clinical setting.