Glycaemic fall after a glucose load. A population-based study

作者：Casiglia E^*; Tikhonoff V; Caffi S; Bascelli A; Guglielmi F; Mazza A; Martini B; Saugo M; D'Este D; Masiero S; Guidotti F; Boschetti G; Schiavon L; Spinella P; de Kreutzenberg S V; De Lazzari F; Pessina A C

来源：Nutrition Metabolism and Cardiovascular Diseases, 2010, 20(10): 727-733.

DOI：10.1016/j.numecd.2009.06.012

• Population
• Epidemiology
• Human
• Metabolic syndrome
• Oral glucose load
• Coronary
• Risk

Background and aims: A blood glucose (BG) fall after an oral glucose load has never been described previously at a population level. This study was aimed at looking for a plasma glucose trend after an oral glucose load for possible blood glucose fall if any, and for its impact on coronary mortality at a population level.
Methods and results: In subjects from an unselected general population, BG and insulin were detected before and 1 and 2 h after a 75-g oral glucose load for insulin sensitivity and beta-cell function determination. Blood pressure, blood examinations and left ventricular mass were measured, and mortality was monitored for 18.8 +/- 7.7 years. According to discriminant analysis, the population was stratified into cluster 0 (1-h BG < fasting BG; n = 497) and cluster 1 (1-h BG >= fasting BG; n = 1733). To avoid any interference of age and sex, statistical analysis was limited to two age gender-matched cohorts of 490 subjects from each cluster (n = 940).
Subjects in cluster 0 showed significantly higher insulin sensitivity and beta-cell function, lower visceral adiposity and lower blood pressure values. Adjusted coronary mortality was 8 times lower in cluster 0 than 1 (p < 0.001). The relative risk of belonging to cluster 1 was 5.40 (95% CI 2.22-13.1).
Conclusion: It seems that two clusters exist in the general population with respect to their response to an oral glucose load, independent of age and gender. Subjects who respond with a BG decrease could represent a privileged sub-population, where insulin sensitivity and beta-cell function are better, some risk factors are less prevalent, and coronary mortality is lower.

• 出版日期2010-12