食後高血糖と食後高脂血症を同時に観察するテストミールＡについて

Abstract

It is now well recognized that both Postprandial hyperglycemia and postprandial hyperlipidemia contribute to the development of atherosclerosis. Both an impaired glucose tolerance (IGT) and hyperglycemia after glucose loading have been reported to be risk factors for coronary arterial disease. Postprandial hyperlipidemia, or an increase in remnant lipoproteins in the plasma after a meal has been recognized as atherogenic. It therefore becomes important to establish an international standard test meal for simultaneously assessing both postprandial hyperglycemia and postprandial hyperlipidemia. Test meal A was developed for this purpose by the Working Group for Test Meals under the Committee of Laboratory Testing for Diabetes Mellitus of the Japan Diabetes Society. Test meal A contains total energy of 450 kcal with 51.4% of carbohydrate, 33.3% of fat and 15.3% of protein. Eighteen diabetics, 12 IGTs and 29 subjects with normal glucose tolerance were enrolled for this study. An oral glucose tolerance test was performed one week after loading with the test meal. There was a close correlation between the blood glucose values 120min. after glucose loading and 120min. after test meal loading. A blood glucose value of 200mg/dl 2 hour after glucose loading corresponds to 150mg/dl at the same sampling point after test meal loading, and a blood glucose value of 140mg/dl 2 hour after glucose loading corresponds to 10mg/dl at the same sampling point after the test meal loading. No significant increase in plasma triglyceride was apparent in the hypertriglyceridemic subjects, while the normotriglyceridemic group showed a significant rise in plasma triglyceride after the test meal loading. The results indicate that test meal A can be applied as a pilot model for the simultaneous assessment of both postprandial hyperglycemia and hyperlipidemia in diabetic subjects.