Two-hour post-load plasma glucose levels are associated with carotid intima-media thickness in subjects with normal glucose tolerance
Two-hour post-load plasma glucose levels are associated with carotid intima-media thickness in subjects with normal glucose tolerance
复制标题
DOI：
10.1111/dme.12288
复制
发表时间：
2014-01-01
影响因子：
3.5
通讯作者：
Kawada, T.
中科院分区：
文献类型：
--
作者：
Kato, K.;Otsuka, T.;Kawada, T.
目的负荷后血糖水平升高可能增加心血管疾病的风险，即使在正常血糖范围内也是如此。在日本糖耐量正常的受试者中，我们研究了颈动脉内膜-中层厚度(早期动脉粥样硬化的标志物)与血糖变量(包括负荷后血糖水平)的相关性。方法研究参与者是663名糖耐量正常的日本受试者(565名男性，平均年龄479岁)，他们在健康体检期间接受了75g口服葡萄糖耐量试验和颈动脉内膜-中层厚度的B型超声测量。观察空腹血糖、糖耐量试验1h和2 h血糖、糖化血红蛋白(1c)与颈总动脉最大内中膜厚度的关系。结果颈动脉内膜中层厚度在1 h血糖、2 h血糖和HbA(1c)三组间逐渐增加。多元线性回归分析显示，2 h血糖(=0.09，P=0.012)、年龄、男性、高血压、血脂异常、吸烟是颈动脉内膜中层厚度的独立影响因素。相反，其他血糖升高变量不是颈动脉内膜-中层厚度的独立决定因素。调整多个潜在危险因素后，2 h血糖最高的高血压患者颈动脉内中膜厚度[0.70(95%CI 0.64~0.76)mm]显著大于正常血压组[0.70(95%CI 0.64~0.76)mm]，最低的2 h血糖[0.60(95%CI 0.58~0.63)mm，P=0.037]。结论日本糖耐量正常的受试者口服葡萄糖耐量试验中的2 h血糖与颈动脉内膜中层厚度呈正相关且独立相关。特别是，2-h血糖升高和高血压的结合可能导致颈动脉内膜-中层厚度增加。
AimsElevated post-load plasma glucose levels may increase the risk of cardiovascular disease, even when they are within the normoglycaemic range. We examined the association of carotid artery intima-media thickness, a marker of early atherosclerosis, with glycaemic variables, including post-load plasma glucose levels, in Japanese subjects with normal glucose tolerance.MethodsThe study participants were 663 Japanese subjects with normal glucose tolerance (565 men, mean age 479years) who underwent both a 75-g oral glucose tolerance test and carotid artery intima-media thickness measurement by B-mode ultrasonography during a health examination. Associations between maximal common carotid artery intima-media thickness and fasting plasma glucose, 1-h and 2-h plasma glucose during an oral glucose tolerance test, and HbA(1c) were examined.ResultsThe carotid artery intima-media thickness gradually increased across the tertiles of 1-h plasma glucose, 2-h plasma glucose and HbA(1c). In multiple linear regression analysis, 2-h plasma glucose (=0.09, P=0.012), as well as age, male gender, hypertension, dyslipidaemia, and current smoking were independent determinants of carotid artery intima-media thickness. In contrast, other glycaemic variables were not independent determinants of carotid artery intima-media thickness. The carotid artery intima-media thickness in hypertensive subjects with the highest tertile of 2-h plasma glucose [0.70 (95%CI 0.64-0.76) mm] was significantly greater than in normotensive subjects, with the lowest tertile of 2-h plasma glucose [0.60 (95%CI 0.58-0.63) mm, P=0.037], even after adjusting for the multiple potential confounders.ConclusionsThe 2-h plasma glucose during an oral glucose tolerance test was positively and independently associated with carotid artery intima-media thickness in Japanese subjects with normal glucose tolerance. In particular, the combination of elevated 2-h plasma glucose and hypertension may contribute to an increased carotid artery intima-media thickness.