Glycemic Response to Oral Dexamethasone Predicts Incident Prediabetes in Normoglycemic Subjects With Parental Diabetes.
Glycemic Response to Oral Dexamethasone Predicts Incident Prediabetes in Normoglycemic Subjects With Parental Diabetes.
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DOI：
10.1210/jendso/bvaa137
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发表时间：
2020-11-01
影响因子：
4.1
通讯作者：
Dagogo-Jack S
中科院分区：
文献类型：
--
作者：
Nyenwe E;James D;Wan J;Dagogo-Jack S
前驱糖尿病是2型糖尿病（T2DM）的一种常被忽视的前兆，与心脏代谢并发症有关。在这里，我们研究了地塞米松挑战在预测父母为2型糖尿病的正常血糖受试者中前驱糖尿病事件的效用，并参与了一项双种族队列研究的前驱糖尿病前瞻性病理生物学研究。通过口服葡萄糖耐量试验（OGTT）记录血糖正常状态后，参与者于晚上10点摄入地塞米松（2 mg），并于第二天早上8点测量空腹血糖（pg - dex）和皮质醇。研究对象每季度随访5年，主要结果是发生前驱糖尿病。系列评估包括身体成分、血液化学、OGTT、胰岛素敏感性和分泌。我们分析了190名参与者的资料（黑人107人，白人83人；平均年龄44.7±10.0岁；体重指数[BMI] 29.8±6.8 kg/m2；空腹血糖[FPG] 90.9±5.7 mg/dL）。地塞米松摄入后，血浆皮质醇< 5µg/dL；FPG- dex水平表现出明显的可变性（81-145 mg/dL）， δ FPG（-7至+48 mg/dL）也是如此。在5年的随访中，190名受试者中有58名（30.5%）进展为前驱糖尿病。FPG- dex（116.8±10.9 vs 106.9±10.8 mg/dL, P < 0.0001）和δ FPG（23.4±10.1 vs 17.0±10.2 mg/dL, P < 0.0001）在进展者中高于非进展者。在包括年龄、种族、性别、BMI、腰围、FPG、胰岛素敏感性和分泌在内的多变量模型中，pg - dex （P = 0.007）是糖尿病前期事件的独立预测因子。在进一步的分析中，pg - dex水平≥107 mg/dL预测前驱糖尿病的敏感性为88%，特异性为49%。地塞米松对血糖的反应可显著预测父母患有2型糖尿病的后代发生前驱糖尿病，可能是发现血糖异常潜在风险的工具。
Prediabetes, an often unrecognized precursor of type 2 diabetes (T2DM), is associated with cardiometabolic complications. Here, we investigated the utility of dexamethasone challenge in predicting incident prediabetes among normoglycemic subjects with parental T2DM enrolled in the prospective Pathobiology of Prediabetes in a Biracial Cohort study. After documenting normoglycemic status with an oral glucose tolerance test (OGTT), participants ingested dexamethasone (2 mg) at 10:00 pm, and fasting plasma glucose (FPG-Dex) and cortisol were measured at 8:00 am the next day. Subjects were followed quarterly for 5 years, the primary outcome being incident prediabetes. Serial assessments included body composition, blood chemistry, OGTT, insulin sensitivity, and secretion. We analyzed data from 190 participants (107 Black, 83 white; mean age 44.7 ± 10.0 years; body mass index [BMI] 29.8 ± 6.8 kg/m2; fasting plasma glucose [FPG] 90.9 ± 5.7 mg/dL). Following dexamethasone ingestion, plasma cortisol was < 5 µg/dL; FPG-Dex levels displayed marked variability (81-145 mg/dL) as did delta FPG (–7 to +48 mg/dL). During 5 years of follow-up, 58 of 190 subjects (30.5%) progressed to prediabetes. FPG-Dex (116.8 ± 10.9 vs 106.9 ± 10.8 mg/dL, P < 0.0001) and delta FPG (23.4 ± 10.1 vs 17.0 ± 10.2 mg/dL, P < 0.0001) were higher in progressors than nonprogressors. FPG-Dex (P = 0.007) was an independent predictor of incident prediabetes in a multivariate model that included age, race, gender, BMI, waist circumference, FPG, insulin sensitivity, and secretion. In further analyses, an FPG-Dex level ≥ 107 mg/dL predicted incident prediabetes with 88% sensitivity and 49% specificity. The glycemic response to dexamethasone significantly predicted incident prediabetes among offspring of parents with T2DM, and may be a tool for uncovering latent risk of dysglycemia.
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影响因子：
158.5
作者：
Knowler, WC;Barrett-Connor, E;Nathan, DM
通讯作者：
Nathan, DM
DOI：
10.1016/j.ecl.2017.10.001
发表时间：
2018-03
影响因子：
4.5
作者：
Brannick B;Dagogo-Jack S
通讯作者：
Dagogo-Jack S
影响因子：
8
作者：
Durck, Tina Trier;Henriksen, Jan Erik;Alford, Frank P.
通讯作者：
Alford, Frank P.
影响因子：
5.8
作者：
Dagogo-Jack, Samuel;Edeoga, Chimaroke;Wan, Jim
通讯作者：
Wan, Jim
影响因子：
--
作者：
Maedler, K;Donath, MY
通讯作者：
Donath, MY