Postload Plasma Glucose Levels Research Articles

One-hour post-load plasma glucose level predicts future type 2 diabetes in a community-based study of Hong Kong Chinese workforce

BackgroundWe compared performance of high 1-hour PG level, impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) in predicting type 2 diabetes in a longitudinal community-based cohort of Hong Kong Chinese. MethodsBetween 2001 and 2003, 472 adults aged 18–55 years without diabetes underwent 75-gram oral glucose tolerance test (OGTT). Between 2012 and 2014, progression to diabetes was ascertained by reviewing medical records or repeating OGTT and HbA1c. We defined high 1-hour PG as PG ≥ 8.6 mmol/L at 1-hour. ResultsIn this cohort, 23.5% had normal glucose tolerance and high 1-hour PG, 10.0% had isolated IGT, 4.2% had isolated IFG. Over 12-year follow-up, 9.3% developed type 2 diabetes. In logistic regression, high 1-hour PG was associated with progression to type 2 diabetes with adjusted odds ratio (95% CI) of 4.20 (1.60, 12.40), independent of IFG, IGT and other clinical variables. Areas under ROC (95% CI) for type 2 diabetes were similar between 1-hour (0.84 [0.78, 0.89], 2-hour (0.79 [0.72, 0.86]) and fasting PG (0.79 [0.71, 0.86]). ConclusionHigh 1-hour PG identified young Chinese with 5-fold increased risk of type 2 diabetes independent of other intermediate hyperglycaemia status and clinical factors. 1-hour PG is similar to fasting and 2-hour PG in predicting type 2 diabetes.

One-hour post-load glucose and subclinical left atrial myocardial dysfunction in hypertensive patients.

Recently, studies demonstrated that normal glucose-tolerant subjects (NGT) with one-hour post load plasma glucose value >155 mg/dl during oral glucose tolerance test (OGTT) (NGT≥155) present an impaired cardio-metabolic profile, with subclinical myocardial damage. Atrial morphological and functional alterations, closely related to diastolic dysfunction, are important predictors of atrial fibrillation (AF), cardiovascular (CV) events, and mortality in the entire population as well as in diabetic patients. The aim of our study was to evaluate subclinical atrial myocardial damage, assessed with speckle tracking echocardiography, in NGT≥155 mg/dl patients, comparing to NGT<155 mg/dl subjects, impaired glucose tolerant (IGT) individuals and patients with newly diagnosed type 2 diabetes (T2DM). We enrolled 229 Caucasian patients. All subjects underwent anthropometrical and hemodynamic parameters evaluation, OGTT, advanced Color-Doppler echocardiography with evaluation of main atrial and ventricular parameters. As expected, from first to the fourth group there was a worsening of the metabolic profile as attested by fasting, one-hour and two-hour post load plasma glucose levels, during OGTT. Moreover, from NGT<155 to T2DM group there was an impairment in reservoir and pump atrial function (PALS and PACS, respectively) (p<0.0001). Present data demonstrated for the first time that NGT≥155 subjects present subclinical atrial dysfunction. These results may be clinically relevant because they highlight how atrial myopathy occurs early in pre-diabetes stage regardless of fibrotic and morphological alterations of the ventricular myocardium.

Impact of healthy lifestyle on the risk of type 2 diabetes mellitus in southwest China: A prospective cohort study

To explore the influence of nine healthy lifestyle factors on the risk of type 2 diabetes mellitus in adults in Guizhou, China. Data were obtained from a large population-based prospective cohort study in Guizhou Province, China. A total of 7,319 participants aged ≥18 years without diabetes at baseline were included in this study and were followed up from 2016 to 2020. A healthy lifestyle score was calculated based on the number of healthy lifestyle factors. During an average of 7.1 person-years of follow-up, 764 participants were diagnosed with type 2 diabetes mellitus. Compared with those of participants who scored 0-3 for a healthy lifestyle, the hazard ratios (95% confidence intervals) of those who scored 4, 5, 6, and ≥7 were 0.676 (0.523-0.874), 0.599 (0.464-0.773), 0.512 (0.390-0.673), and 0.393 (0.282-0.550), respectively, showing a gradual downward trend (P for trend <0.01). More importantly, they had lower fasting and 2 h post-load plasma glucose levels and fewer changes in plasma glucose levels during follow-up. If ≥7 healthy lifestyle factors were maintained, 33.8% of incident diabetes cases could have been prevented. Never smoking was the strongest protective factor against type 2 diabetes mellitus. A healthy lifestyle can effectively decrease plasma glucose levels and reduce the incidence of type 2 diabetes mellitus in adults in Guizhou, China. In addition, not smoking may be an effective way to prevent type 2 diabetes mellitus.

Analysis of HIF2α polymorphisms in infertile women with polycystic ovary syndrome or unexplained infertility

ObjectiveTo evaluate HIF2α polymorphisms and glucose metabolism in a group of women with polycystic ovary syndrome (PCOS) or unexplained infertility (UI).PatientsThe infertile group (n=148) consisted of 96 women with PCOS, 52 women with UI, and176 women without infertility as a healthy control group.InterventionWe genotyped 29 single nucleotide polymorphisms (SNPs) of HIF2α by using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS)-based genotyping technology. The genetic associations were analyzed statistically.Main outcome measuresAllele frequency, genotype distribution and haplotype analyze of the HIF2α polymorphisms were performed. Body mass index (BMI), waist circumference, uric acid (UA), high-sensitivity C-reactive protein (hsCRP), lipids, glucose and insulin tolerance - were also measured.ResultsInfertile women with PCOS had a higherBMI and waist circumference, elevated hsCRP and uric acid (UA) levels, impaired glucose tolerance, and increased levels of plasma insulin compared to UI patients and healthy women. SNP analysis of HIF2α revealed that the allele and genotype frequencies of rs4953361 were significantly associated with infertile women with PCOS. Haplotype analysis of the HIF2α polymorphism identified haplotypes TGG and TGA as being associated with infertile women with PCOS. Women with the AA genotype of rs4953361 had a significantly higher BMI and post load plasma glucose and insulin levels than those of women with the GG genotype.ConclusionInfertile women with PCOS more commonly have metabolic disturbances than those with UI. This is the first study to report an association between HIF2α polymorphisms (rs4953361) and the risk of infertile women with PCOS, not UI, in Han Chinese population. These results require replication in larger populations.In this observational study, we did not report the results of a health care intervention on human participants. The study was approved by the Human Research Ethics Committee of the First Affiliated Hospital of Chongqing Medical University. Clinical data and peripheral blood samples were collected only after explaining the objectives of the study and obtaining a signed informed consent form.

One-hour plasma glucose level after a 75 g oral glucose load and its relationship to gastric emptying in survivors of critical illness and stress hyperglycaemia

Objective: A 1-hour plasma glucose level ≥ 8.6 mmol/L in a 75 g oral glucose tolerance test has been strongly associated with increased morbidity and mortality in outpatients without diabetes. Our primary aim was to evaluate the 1-hour plasma glucose level in a 75 g glucose tolerance test in survivors of critical illness with stress hyperglycaemia at 3 months after intensive care unit (ICU) discharge, with the secondary aims to evaluate the 2-hour plasma glucose level, glycated haemoglobin (HbA1c), and gastric emptying. Design:Post hoc analysis of a single-centre, prospective cohort study. Setting: Single-centre, tertiary referral, mixed medical-surgical ICU. Participants: Consecutively admitted patients aged ≥ 18 years who developed stress hyperglycaemia and survived to hospital discharge were eligible. Interventions: Participants returned at 3 months after ICU discharge and underwent a 75 g oral glucose tolerance test. Main outcome measures: One- and 2-hour post load plasma glucose level, HbA1c, and assessment of gastric emptying via an isotope breath test. Results: Thirty-five patients (12 females; mean age, 58.5 years [SD, 10.5]; mean HbA1c, 37.4 mmol/mol [SD, 7.0]) attended the followup. In 32/35 patients (91%) the 1-hour post load plasma glucose level was ≥ 8.6 mmol/L. There was a positive correlation between the plasma glucose level at 1 hour (r2 = 0.21; P = 0.006), but no correlation between the 2-hour glucose level (r2 = 0.006; P = 0.63) and gastric emptying. Conclusion: Glucose intolerance, when defined as 1-hour glucose level ≥ 8.6 mmol/L following a 75 g oral glucose load, persists at 3 months in most survivors of stress hyperglycaemia and is dependent on the rate of gastric emptying. Longitudinal studies to characterise mechanisms underlying dysglycaemia and progression to diabetes in individuals with stress hyperglycaemia are indicated.

One-Hour Post-Load Plasma Glucose Levels are Associated with Early Arterial Stiffness in Subjects with Different Glucose Tolerance.

ObjectiveThe purpose of this study was to explore the relationship between one-hour post-load plasma glucose levels and early arterial stiffness in subjects with different glucose tolerance.MethodsThis case-control study included 57 subjects with normal glucose tolerance, 38 subjects with pre-diabetes, and 30 subjects with type 2 diabetes. All subjects underwent an oral glucose tolerance test (OGTT) with 75 g of oral anhydrous glucose at 8:00 AM. The brachial-ankle pulse wave velocity (baPWV) was used as a surrogate marker of early arterial stiffness.ResultsbaPWV was significantly higher in the diabetes group than in the normal glucose tolerance group (diabetes group: 1501.8 ± 270.4 cm/s, pre-diabetes group: 1428.6 ± 173.1 cm/s vs normal glucose tolerance group: 1368.0 ± 242.8 cm/s) (p < 0.05). baPWV was positively correlated with age (r = 0.512, p < 0.001), systolic blood pressure (SBP) (r = 0.526, p < 0.001), diastolic blood pressure (DBP) (r = 0.298, p = 0.001), fasting plasma glucose (FPG) (r = 0.213, p = 0.017), 1-h plasma glucose levels from the OGTT (r = 0.407, p < 0.001) and 2-h plasma glucose levels from the OGTT (r = 0.202, p = 0.024). When baPWV was considered as the dependent variable in a multiple regression analysis, the 1-h plasma glucose level from the OGTT maintained an independent association with baPWV (β = 23.129, 95% CI: 8.142–38.115, p = 0.003, R2 = 0.036).ConclusionThe present study demonstrated the presence of early arterial stiffness in diabetes. Elevated 1-hour post-load plasma glucose level is closely related to the change of arterial elasticity in diabetes.

Characteristics of the glycometabolic categories based on the oral glucose tolerance test results in Japanese adults without diabetes.

We aimed to classify Japanese adults without diabetes into different categories based on the oral glucose tolerance test (OGTT) and characterize their insulin sensitivity and insulin secretion. The OGTT was performed on 1,085 Japanese individuals without diabetes (aged 20-64 years); blood glucose and insulin levels were measured at 0, 30-, 60-, 90-, and 120-min. Fasting blood chemistry, hematology, and urine were analyzed. The participants were classified into four categories based on the following: (A) 30 min post-load plasma glucose levels < 157 mg/dL and/or (B) 120 min post-load plasma glucose levels < 126 mg/dL and Matsuda index > 4.97. Category 1 satisfied both conditions, category 2 satisfied condition A but not B, category 3 satisfied condition B but not A, and category 4 satisfied neither condition. Overall, 46%, 21%, 13%, and 20% of the participants were classified into categories 1, 2, 3, and 4, respectively. Compared with category 1, the characteristics of the other categories were: 2, low insulin sensitivity and high blood glucose levels during the later period; 3, low insulin secretion and a rapid increase in blood glucose levels; and 4, combined characteristics of categories 2 and 3. Most blood test values besides glucose metabolism in category 4 were also worse than those in category 1. Categories 1 and 2 had a high proportion of females, whereas categories 3 and 4 had a low proportion. Japanese adults without diabetes are classified into four categories with different insulin sensitivities and insulin secretion using OGTT results. Each category has different characteristics of age and sex distribution and clinical values besides glucose metabolism.

Biological and sociocultural determinants of increased blood pressure among women with a history of gestational diabetes mellitus in rural China: a retrospective cohort study

ObjectivesGestational diabetes mellitus (GDM) increases the risk of hypertension and cardiovascular events among mothers later in life. This risk has not been well recognised by healthcare professionals in rural China....

Acute effects of whole body vibration exercise on post-load glucose metabolism in healthy men: a pilot randomized crossover trial.

PurposeExercise on a whole body vibration (WBV) platform, namely WBV exercise (WBVE), has long-term beneficial effects on glucose metabolism, similarly to conventional moderate-intensity exercise. Conventional moderate-intensity exercise reduces post-load plasma glucose levels at the acute phase. This study aimed to reveal acute effects of WBVE on post-load glucose metabolism.MethodsThis randomized crossover trial enrolled 18 healthy men. They completed the following three interventions in a random order: (1) a 2-hour 75-g oral glucose tolerance test (OGTT) without WBVE (OGTT-alone), (2) 20-minute WBVE before an OGTT (WBVE → OGTT), and (3) 20-minute WBVE during an OGTT (OGTT → WBVE). Post-load glucose metabolism in the WBVE → OGTT and OGTT → WBVE interventions were compared with that in the OGTT-alone intervention.ResultsPlasma glucose levels in the WBVE → OGTT and OGTT → WBVE interventions were not significantly different from those in the OGTT-alone intervention at any time point except 15 min, wherein the WBVE → OGTT intervention had higher glucose levels (111 [interquartile range, 102–122] mg/dL vs 122 [111–134] mg/dL, P = 0.026). Higher plasma glucagon levels were observed at 0 min in the WBVE → OGTT intervention and at 60 min in the OGTT → WBVE intervention (P = 0.010 and 0.015). Cortisol, Growth hormone, and adrenaline levels were significantly increased after WBVE, whereas noradrenaline levels were not. Serum insulin levels in the WBVE → OGTT intervention were significantly higher than those in the OGTT-alone intervention at 0 min (P = 0.008).ConclusionsWBVE did not decrease post-load plasma glucose levels at the acute phase. Acute effects of WBVE on post-load glucose metabolism would not be identical to those of conventional exercise.The unique trial number and the name of the registry: UMIN000036520, www.umin.ac.jp, date of registration, June 12, 2019.

Diversity in the risk of type 2 diabetes associated with age, sex, and 1-h post-load plasma glucose levels in the Japanese population with prediabetes

AimsWe investigated the risk of type 2 diabetes in the Japanese population with prediabetes, focusing on prediabetes categories, age- and sex-related differences, and plasma glucose levels during a 75-g oral glucose tolerance test. MethodsThis retrospective cohort study included 11,414 participants (5330, 2560, 1501, and 2023 with normal fasting glucose/normal glucose tolerance, isolated impaired fasting glucose [IFG], isolated impaired glucose tolerance [IGT], and IFG plus IGT, respectively). The risk of type 2 diabetes was stratified by age and sex. Moreover, prediabetes was subdivided according to fasting plasma glucose (FPG) and 1-h post-load glucose levels. ResultsOver a mean 6.3-year follow-up period, 1002 participants developed type 2 diabetes. The risk of type 2 diabetes was higher in isolated IFG than isolated IGT in elderly participants, but not in middle-aged participants. A higher risk was evident in isolated IFG in women, but not men. Moreover, about a 27- and 29-fold difference exists in men and women, respectively, in the risk of type 2 diabetes among the subdivided prediabetes categories. ConclusionThe assessment of age and sex-differences and subdivided prediabetes categories based on FPG and 1-h post-load glucose levels may effectively evaluate the risk of type 2 diabetes, which displays marked diversity.

One-hour postload plasma glucose levels as a new criterion for assessing insulin secretion in obese children

BACKGROUND: Incidence of Type 2 Diabetes Mellitus (T2DM) and associated dysglycemic conditions, increasing the risk of diabetes development, continues to rise worldwide, most notably due to ever-growing obesity rate. Early identification of the persons who are exposed to the risk of T2DM development holds much significance for prevention of both this disease and associated cardiometabolic complications.AIM: To study characteristics of insulin secretion and insulin sensitivity among obese children and adolescents versus the glycemic level 60 minutes (GL60) after the standard oral glucose tolerance test (OGTT).METHODS: This open-label comparative cross-sectional study involved 613 children in the age between 6 and 17.9 years old with constitutive-exogenous obesity, divided into 2 groups: 173 patients with GL60 level ≥ 8.6 mmol/L and 440 children with GL60 level &lt; 8.6 mmol/L. They underwent a screening for dyslipidemia, non-alcoholic fatty liver disease, arterial hypertension and impaired glucose tolerance (IGT). Insulin secretion was evaluated on the basis of maximal (IRI max), average level (IRI avg) of insulin in the course of OGTT and insulinogenic index (IGI), insulin resistance (IG) — by Matsuda index.RESULTS: The groups were comparable in the terms of age, sex, sexual maturation stage and obesity level. Children with GL60 level ≥ 8.6 mmol/L were characterized by higher IR (Matsuda 2.8 ± 2.3 vs 3.5 ± 2.2, р &lt; 0.01), hyperinsulinemia (IRI max 190.0 ± 59.5 vs 157.1 ± 63.4 μU/ml, р &lt; 0.001, IRI avg 115.3 ± 59.7 vs 90.2 ± 54.1 μU/ml, p &lt; 0.001) along with low IGI value (1.84 ± 1.62 vs 2.61 ± 1.3, р &lt; 0.01), which is indicative of the first phase insulin secretion impairment. The lowest IGI values were found among the "GL60 level ≥ 8.6 mmol/L" group patients with IGT (1.4 ± 0.9). Besides, the patients with GL60 level ≥ 8.6 mmol/L are characterized by the higher rate of metabolic complications in the form of impaired glucose tolerance, arterial hypertension, fatty hepatosis and steatohepatitis.CONCLUSIONS: GL60 level ≥ 8.6 mmol/L can be used as an additional marker for metabolically complicated obesity among children and adolescents with a high risk of the carbohydrate metabolism disorder development.

Two-hour postload plasma glucose and pigment epithelium-derived factor levels are markers of coronary artery inflammation in type 2 diabetic patients

BackgroundWe have previously found that pioglitazone attenuates inflammation in the left main trunk of coronary artery (LMT), evaluated as target-to-background ratio (TBR) by 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) in patients with impaired glucose tolerance or type 2 diabetes. ObjectivesWe assessed which clinical variables could predict the change in TBR in the LMT after 4-month add-on therapy with oral hypoglycemic agents (OHAs). MethodsA total of 38 type 2 diabetic patients with carotid atherosclerosis who had already received OHAs except for pioglitazone was enrolled. At baseline and 4 months after add-on therapy with pioglitazone or glimepiride, all patients underwent 75 g oral glucose tolerance test, blood chemistry analysis, and FDG-PET/CT. ResultsFasting plasma glucose, 30-, 60-, 90-, 120-minutes postload plasma glucose, HbA1c, and LMT-TBR values were significantly decreased by add-on therapy, whereas high-density lipoprotein-cholesterol and adiponectin levels were increased. Increased serum levels of pigment epithelium-derived factor (PEDF), a marker of insulin resistance and non-use of aspirin at baseline could predict the favorable response of LMT-TBR to add-on therapy. Moreover, Δ120-minutes postload plasma glucose and ΔPEDF were independent correlates of ΔLMT-TBR. ConclusionsOur present study suggests that 120-minutes postload plasma glucose and PEDF values may be markers and potential therapeutic targets of coronary artery inflammation in type 2 diabetic patients. Clinical Trial RegistrationURL: http://clinicaltrials.gov. Unique identifier: NCT00722631. Graphic AbstractNew markers for diabetes and CAD is on the horizon! Two-hour postload plasma glucose and pigment epithelium derived factor are markers of coronary artery inflammation in type 2 diabetic patients.▪

Glucomannan Inhibits Rice Gruel-Induced Increases in Plasma Glucose and Insulin Levels

Objective: Given the association between diabetes suppression and inhibition of diet-induced elevation in glucose and insulin, we investigated the effects of adding glucomannan to rice gruel on pre- and postprandial glucose and insulin concentrations. Methods: A total of 25 Japanese subjects without a history of diabetes or gastrointestinal disease (all males; aged 37–60 years; body mass index 20.4–31.6) participated in this study. Subjects received a 75-g oral glucose tolerance test (75gOGTT) and rice gruel containing 0, 0.4, or 0.8% of glucomannan. Blood samples were then obtained at preload and at 30, 60, and 120 min after receiving 75 g of glucose or rice gruel with or without glucomannan. Results: After the 75gOGTT, 8 subjects had normal glucose tolerance (NGT), whereas 17 showed a borderline pattern. Moreover, our data showed that greater amounts of glucomannan promoted lesser 30-min postload plasma glucose and insulin levels, with differences being larger in the borderline group than in the NGT group. Conclusions: Glucomannan dose-dependently inhibited the rice gruel-induced increase in 30-min postprandial plasma glucose and insulin levels. Furthermore, greater inhibitory effects on glucose and insulin elevation were observed in the borderline group than in the NGT group.

30-minute postload plasma glucose levels during an oral glucose tolerance test predict the risk of future type 2 diabetes: the Hisayama Study

IntroductionTo investigate the associations of 30 min postload plasma glucose (30 mPG) levels during an oral glucose tolerance test (OGTT) with the risk of future diabetes in a general Japanese...

Telomere length in different metabolic categories: Clinical associations and modification potential.

Metabolic disorders are known to be associated with accelerated telomere attrition. Their pathophysiological heterogeneity suggests the importance of multiple tests in examining these associations. However, oral glucose tolerance test (OGTT) has rarely been performed in such studies to date. There are few studies aimed at determining leukocyte telomere length (LTL) in different categories of impaired glucose tolerance (IGT), and those that do exist do not take into account the impaired fasting glucose (IFG)/IGT categorization. Therefore, we believe our study, when the OGTT was used, is important to the field. This testing made it possible to determine whether LTLs are associated with glucose levels in different hyperglycemic categories. Our data indicate that relationships between LTLs and IFG/IGT levels are not the same. This distinction can potentially be used in categorization of metabolic disorders and in determining the effectiveness of interventions aimed at treating diabetes and other metabolic abnormalities.

1439-P: One-Hour Postload Plasma Glucose Level Predicts Future Type 2 Diabetes in Hong Kong Chinese: A 12-Year Follow-Up Analysis

Background: There is a resurgence of interest in the role of 1-hour post-load plasma glucose (PG) in risk stratification for type 2 diabetes and a cut-off of 8.6 mmol/L has been proposed to define dysglycaemia in addition to other existing criteria of prediabetes. We examined the efficacy of 1-hour PG level in predicting future type 2 diabetes in a longitudinal community-based cohort of Hong Kong Chinese. Methods: Between 2001-2003, 489 adults without diabetes underwent 75-gram oral glucose tolerance test (OGTT). Blood samples were collected at 0, 15, 30, 60 and 120 minutes for measurement of plasma glucose and insulin levels. Between 2012-2014, progression to diabetes was ascertained either by reviewing medical records or by repeating OGTT and HbA1c. Area under the receiver-operating characteristic (ROC) curve was calculated to assess the discrimination of each parameter (fasting PG, 1-hour PG, 2-hour PG, disposition index) for development of diabetes. High 1-hour PG was defined using threshold of 8.6 mmol/L. Results: Over 12-year follow-up, 46 people (9.4%) developed diabetes. The area under ROC curve were 0.79 (95% CI 0.71, 0.86) for fasting PG, 0.84 (95% CI 0.78, 0.89) for 1-hour PG, 0.79 (95% CI 0.72, 0.86) for 2-hour PG, and 0.78 (95% CI 0.71, 0.85) for disposition index with no difference between each parameter. In multivariate logistic regression, high 1-hour PG was associated with new-onset diabetes with odds ratio (OR) 4.87 (95% CI 1.91, 14.1, p=0.002), independent of impaired fasting glucose (OR 2.19 [95% CI 0.87, 5.32, p=NA), impaired glucose tolerance (OR 3.69 [95% CI 1.67, 8.27, p=0.001]) and other clinical variables including age, sex, smoking, family history of diabetes, history of gestational diabetes, waist and blood pressure. Conclusions: One-hour PG is similar to fasting and 2-hour PG in prediction of type 2 diabetes. High 1-hour PG identifies people with high risk of diabetes independent of other criteria of prediabetes and clinical risk factors. Disclosure A. Luk: Research Support; Self; Bayer Healthcare Pharmaceuticals Inc., Roche Pharma. Other Relationship; Self; Merck Sharp &amp; Dohme Corp. E.S. Lau: None. A.P. Kong: Advisory Panel; Self; Eli Lilly and Company. Research Support; Self; AstraZeneca. Speaker’s Bureau; Self; Abbott, AstraZeneca, Sanofi. Other Relationship; Self; AstraZeneca, Novartis Pharmaceuticals Corporation, Sanofi. E. Chow: None. R.C. Ma: Advisory Panel; Self; AstraZeneca. Stock/Shareholder; Self; GemVCare. Other Relationship; Self; AstraZeneca, Bayer Healthcare Pharmaceuticals Inc., Merck &amp; Co., Inc., Novo Nordisk A/S, Pfizer Inc., Sanofi-Aventis, Tricida Inc. J.C. Chan: None.

Elevated 1-h post-load plasma glucose levels in normal glucose tolerance children with obesity is associated with early carotid atherosclerosis

ContextEvidence suggests that the 1-h post-load plasma glucose (1-h PG) ≥155mg/dL during an oral glucose tolerance test (OGTT) predicts development of type 2 diabetes (T2DM) and associated complications, among adults with normal glucose tolerance (NGT), but relevant data on children is scarce. ObjectivesTo investigate whether NGT children with obesity whose 1-h PG is ≥155mg/dL have an increased carotid intima-media thickness (IMT) and exhibit non-alcoholic fatty liver disease (NAFLD) diagnosed by ultrasonography, as compared with NGT subjects with 1-h PG <155mg/dL and impaired glucose tolerance (IGT). MethodsCardio-metabolic profile, OGTT, measurements of carotid IMT and liver ultrasonography were analyzed in 171 non-diabetic children with obesity. Subjects were divided into 3 groups: NGT subjects with a 1-h PG <155mg/dL, NGT subjects with a 1-h PG ≥155mg/dL, and IGT subjects. ResultsAs compared with NGT individuals with a 1-h PG <155mg/dL, NGT individuals with a 1-h PG ≥155mg/dL exhibited higher carotid IMT (0.75±0.15mm vs. 0.68±0.15mm; p<0.05). No significant differences were observed in carotid IMT between IGT and NGT subjects with a 1-h PG ≥155mg/dL (0.75±0.18mm vs 0.75±0.15mm; p>0.05). Of the three glycemic parameters, 1-h and 2-h PG, but not fasting glucose, were significantly correlated with carotid IMT. There were no significant differences for increased risk of having NAFLD between the three groups. ConclusionsThese data suggest that a value of 1-h PG ≥155mg/dL in children and adolescents with obesity is as important as IGT with respect to cardiovascular risks.

Elevated 1-h postload plasma glucose levels identify coronary heart disease patients with greater severity of coronary artery lesions and higher risk of 1-year re-admission.

Objective:To investigate the relationship of 1-h postload plasma glucose during the oral glucose tolerance test with the severity of coronary artery lesions and risk of 1-year re-admission in coronary heart disease patients with normal glucose tolerance.Methods:A total of 266 consecutive coronary heart disease patients who underwent coronary angiography and had normal glucose tolerance confirmed by oral glucose tolerance test during hospitalization were prospectively enrolled and followed in two groups according to the 1-h postload plasma glucose cut-off point (1-h postload plasma glucose <155 mg/dL, n = 149 and 1-h postload plasma glucose ⩾155 mg/dL, n = 117). Angiographic severity was assessed by number of diseased vessels, lesion morphology and Gensini score. The risk of 1-year re-admission with adverse cardiovascular events after discharge was analysed.Results:Subjects with a 1-h postload plasma glucose ⩾155 mg/dL had higher incidence of multivessel disease and complex lesions, Gensini score and risk of 1-year re-admission than subjects with a 1-h postload plasma glucose <155 mg/dL (all p < 0.05). In the stepwise multivariate regression analysis, 1-h postload plasma glucose was the major determinant of the Gensini score. Subgroup analyses by sex showed that men with a 1-h postload plasma glucose ⩾155 mg/dL had higher incidence of complex lesions and risk of 1-year re-admission than men with a 1-h postload plasma glucose <155 mg/dL (all p < 0.05).Conclusion:Coronary heart disease patients with normal glucose tolerance and elevated 1-h postload plasma glucose levels had a greater severity of coronary artery lesions and an increased risk of re-admission with adverse cardiovascular events, particularly in men.

1647-P: High Serum YKL-40 Concentration Is Associated with One-Hour Post-Load Hyperglycemia

Objective: Postprandial hyperglycemia is associated with oxidative stress and low-grade inflammation, which is involved in the pathogenesis of cardiovascular disease. The aim of this study was to examine whether post-load plasma glucose during oral glucose tolerance tests (OGTT) affect inflammatory biomarkers in nondiabetic subjects. Methods: We recruited 322 nondiabetic Japanese subjects including 252 with a normal glucose tolerance (NGT) and 70 with an impaired glucose tolerance (IGT). All subjects underwent OGTT and measurement of several inflammatory biomarkers. Results: No significant differences were observed in white blood cell counts, high-sensitive CRP, high-mobility group box 1 protein (HMGB1) or S100A8/A9 levels between NGT subjects with 1-h post-load plasma glucose (1h-PG) &amp;lt; 155 mg/dL and subjects with 1h-PG ≥ 155 mg/dL. Conversely, NGT subjects with 1h-PG ≥ 155 mg/dL exhibited higher YKL-40 levels than subjects with 1h-PG &amp;lt; 155mg/dL (101.6 ± 85.8 vs. 61.6 ± 53.9 ng/mL, P &amp;lt; 0.0001). No significant difference was observed in YKL-40 levels between NGT subjects with 1h-PG ≥ 155 mg/dL and subjects with IGT. YKL-40 levels, but not white blood cell counts, high-sensitivity CRP, HMGB1 or S100A8/A9, showed significantly positive correlations with 1h-PG (r = 0.251, P &amp;lt; 0.0001). Multiple regression analysis showed that YKL-40 levels were independently associated with 1h-PG, as were age, gender, alanine transaminase and systolic blood pressure. Conclusions: In nondiabetic subjects, serum YKL-40 levels correlated positively with post-load plasma glucose levels. YKL-40 is produced by several cell types such as activated macrophages, vascular smooth muscle and endothelial cells, and plays an important role in the innate immune response, angiogenesis and remodeling of extracellular matrix. Elevated YKL-40 levels related to postprandial hyperglycemia may contribute to the progression of atherosclerosis and cardiovascular events. Disclosure Y. Ikeda: None. N. Hisakawa: None. H. Takata: None. T. Ohguro: None. J. Nishiuchi: None. Y. Kumon: None.

Additional Impact of Glucose Tolerance on Telomere Length in Persons With and Without Metabolic Syndrome in the Elderly Ukraine Population.

Rationale: Association between different components of metabolic syndrome and the rate of age-related telomere shortening was reported repeatedly, although some findings are inconsistent across studies, suggesting the need for further research on the topic. In the present study, we examined relationships between different components of metabolic syndrome (MetS); glucose tolerance reflected in 2-h post-load plasma glucose (2hPG) levels and age on the leukocyte telomere length (LTL) in Ukraine population.Methods: The study was conducted on the 115 adult individuals residing in the Kyiv region (Ukraine). Among them, 79 were diagnosed with MetS according to the International Diabetes Federation definition. LTL were determined by a qPCR-based method. Multivariate logistic regression (MLR) and artificial neural networks (ANN) modeling were used for the analysis of the results. ROC-analysis was also performed to compare the predictively values of this models.Results: MetS was associated with a high (OR = 3.0 CI 1.3–6.7; p = 0.01) risk of having shorter telomeres that remained significant after adjusting for age, gender and 2hPG levels. Fasting plasma glucose (FPG) levels and other MetS components did not affect the magnitude of the relationship and did not reveal the independent influence of these factors. The level of 2hPG in turn, demonstrated a significant relationship (OR = 1.3 CI 1.0–1.6 per 1 mmol/l; p = 0.04) with LTL regardless of the presence of MetS. The non-linearity of the interactions between age, gender and 2hPG level was revealed by neural network modeling (AUC = 0.76 CI 0.68–0.84).Conclusion: Our study found that impaired glucose tolerance, but not FPG levels, affected the association between LTL and MetS, which may be also indicative for pathophysiological differences in these hyperglycemia categories. 2hPG levels can provide an opportunity for a more accurate diagnostics of MetS and for evaluating the rate of aging in patients with MetS. Further research, however, is needed to verify this assumption.