Elevated 1-Hour Postload Plasma Glucose Levels Identify Subjects With Normal Glucose Tolerance but Impaired β-Cell Function, Insulin Resistance, and Worse Cardiovascular Risk Profile: The GENFIEV Study

Bianchi, Cristina; Miccoli, Roberto; Trombetta, Maddalena; Giorgino, Francesco; Frontoni, Simona; Faloia, Emanuela; Marchesini, Giulio; Dolci, Maria; Cavalot, Franco; Cavallo, Maria Gisella; Leonetti, Frida; Bonadonna, Riccardo C.; Prato, Stefano Del

doi:10.1210/jc.2012-3971

Cited by 105 publications

(91 citation statements)

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“…The pathophysiological significance of elevated 1-h blood glucose levels is not (10,19,20). In subjects with NGT, an elevated 1-h glucose level is associated with insulin resistance to a degree similar to that seen among individuals with IGT.…”

Section: Discussionmentioning

confidence: 99%

“…Elevated glucose levels at 1 h are associated with adverse metabolic and cardiovascular changes, reflected by body composition, cholesterol levels, and subclinical target organ damage, including arterial stiffness, carotid intimamedia thickness, and left ventricular hypertrophy (19,20,(29)(30)(31). However, very few reports of the clinical consequences have been published (32)(33)(34)(35), and although associations with macrovascular events and mortality have been shown, only one study of 1,945 subjects included glucose levels at 2 h and indicated that 1-h glucose levels predicted all-cause mortality among subjects with NGT (35).…”

Section: Discussionmentioning

confidence: 99%

“…Accumulating longitudinal evidence, pioneered in particular by Abdul-Ghani and colleagues (10)(11)(12)(13)(14)(15)(16)(17)(18), suggests that the 1-h postload glucose level during OGTT with a cutoff $8.6 mmol/L (155 mg/dL) may be an early marker of IGT and subsequent type 2 diabetes that is potentially more useful than either fasting or 2-h glucose levels. Furthermore, from a pathophysiological perspective, the 1-h glucose level is intriguing owing to its seemingly strong correlation with markers of both insulin secretion and sensitivity (10,19,20). However, practical clinical implications of using a 1-h glucose measurement for prediction of type 2 diabetes and its associated complications are less clear.…”

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Enhanced Predictive Capability of a 1-Hour Oral Glucose Tolerance Test: A Prospective Population-Based Cohort Study

et al. 2017

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OBJECTIVETo examine whether the 1-h blood glucose measurement would be a more suitable screening tool for assessing the risk of diabetes and its complications than the 2-h measurement. RESEARCH DESIGN AND METHODSWe conducted a prospective population-based cohort study of 4,867 men, randomly selected from prespecified birth cohorts between 1921 and 1949, who underwent an oral glucose tolerance test with blood glucose measurements at 0, 1, and 2 h. Subjects were followed for up to 39 years, with registry-based recording of events. Discriminative abilities of elevated 1-h ( ‡8.6 mmol/L) versus 2-h ( ‡7.8 mmol/L) glucose for predicting incident type 2 diabetes, vascular complications, and mortality were compared using Kaplan-Meier analysis, Cox proportional hazards regression, and net reclassification improvement. ), 636 (13%) developed type 2 diabetes. Elevated 1-h glucose was associated with incident diabetes (hazard ratio 3.40 [95% CI 2.90-3.98], P < 0.001) and provided better risk assessment than impaired glucose tolerance (Harrell concordance index 0.637 vs. 0.511, P < 0.001). Addition of a 1-h measurement in subjects stratified by fasting glucose provided greater net reclassification improvement than the addition of a 2-h measurement (0.214 vs. 0.016, respectively). Finally, the 1-h glucose was significantly associated with vascular complications and mortality. RESULTS Median age was 48 years (interquartile range [IQR] 48-49). During follow-up (median 33 years CONCLUSIONSThe 1-h blood glucose level is a stronger predictor of future type 2 diabetes than the 2-h level and is associated with diabetes complications and mortality.Type 2 diabetes is associated with significant morbidity and mortality and represents a major burden on health care systems worldwide (1,2). Several randomized clinical trials provide evidence that type 2 diabetes can be prevented or at least postponed with lifestyle modification and drug therapy, which makes identifying high-risk individuals particularly important (3-6). Traditionally, prediabetes has been defined as impaired fasting glucose (IFG) or impaired glucose tolerance (IGT) during a 2-h oral glucose tolerance test (OGTT), and interventional studies thus far have predominantly included subjects with IGT (7,8). However, not all subjects with prediabetes develop type 2

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Enhanced Predictive Capability of a 1-Hour Oral Glucose Tolerance Test: A Prospective Population-Based Cohort Study

et al. 2017

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“…[15][16][17][18][19] In addition, this glucose cutoff is able to identify subjects with an impaired cardiometabolic profile, characterized by high blood pressure, dyslipidemia, liver steatosis, early signs of atherosclerosis, as well as an increased mortality. [20][21][22][23][24][25] In children and adolescents, data on 1-hour postload glucose are not as extensive as in adults, but some preliminary studies have confirmed that a cutoff of 155 mg/dl, or even of 132 mg/dl, could predict future risk of T2D and identify young subjects with early cardiovascular abnormalities.…”

Section: Prediabetes and Other Earlier Forms Of Dysglycemiamentioning

confidence: 99%

Complications of Acute and Chronic Hyperglycemia

Marcovecchio¹

2017

US Endocrinology

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Hyperglycemia is due to a dysregulation in the complex mechanisms implicated in glucose homeostasis. Chronic hyperglycemia, as measured by hemoglobin A1c (HbA1c), is a key risk factor for the development of microvascular and macrovascular complications, which in turn negatively influence the prognosis of patients with diabetes. Several studies have shown that acute hyperglycemia can add to the effect of chronic hyperglycemia in inducing tissue damage. Acute hyperglycemia can manifest as high fasting plasma glucose (FPG) or high postprandial plasma glucose (PPG) and can activate the same metabolic and hemodynamic pathways as chronic hyperglycemia. Glucose variability, as expressed by the intraday glucose fluctuations from peaks to nadirs, is another important parameter, which has emerged as an HbA1c-independent risk factor for the development of vascular complications, mainly in the context of type 2 diabetes. Treatments able to decrease HbA1c have been associated with positive effects in terms of reducing risk for the development and progression of complications. Further studies are required to clarify the impact of strategies more specifically targeting components of acute hyperglycemia, to improve outcomes in patients with diabetes. KeywordsHyperglycemia, complications, vascular, acute, chronic Disclosure: M Loredana Marcovecchio has nothing to disclose in relation to this article. No funding was received in the publication of this article. This study involves a review of the literature and did not involve any studies with human or animal subjects performed by any of the authors.Authorship: Thel named author meets the International Committee of Medical Journal Editors (ICMJE) criteria for authorship of this manuscript, takes responsibility for the integrity of the work as a whole, and has given final approval to the version to be published.Open Access: This article is published under the Creative Commons Attribution Noncommercial License, which permits any non-commercial use, distribution, adaptation and reproduction provided the original author(s) and source are given appropriate credit. From glucose homeostasis to hyperglycemiaGlucose homeostasis is maintained by a complex neurohormonal system, which modulates peripheral glucose uptake, hepatic glucose production, and exogenous glucose utilization following food ingestion.1,2 This allows the maintenance of plasma glucose concentrations within normal range, with average values of around 90 mg/dl throughout a 24-hour period, postmeal concentration below 140 mg/dl, and minimal values, such as those after moderate fasting or exercise, above 55 mg/dl. 1,2Hormones implicated in glucose regulation include insulin, glucagon, amylin, glucagon-like petide-1 (GLP-1), glucose-dependent insulinotropic peptide, epinephrine, cortisol, and growth hormone. These hormones act on several target tissues, including muscle, liver, adipocyte, and brain to regulate glucose levels. 3Insulin is a key glucoregulatory hormone, produced by pancreatic β-cells, whose levels are low durin...

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“…В условиях ранней диагнос-тики повышенного артериального давления (АД) в амбулаторном и стационарном периодах медицинской помощи все большее значение приобретает наличие у пациентов различных факторов риска сердечно-сосудистых осложнений (ССО), определяющих лечеб-К Л И Н И Ц И С Т № 2'2015 О р и г и н а л ь н ы е и с с л е д о в а н и я ную тактику и индивидуальный прогноз [2,3]. Интерес представляют нарушения нутритивного статуса, угле-водного и липидного метаболизма, способствующие по результатам многочисленных исследований не толь-ко раннему дебюту артериальной гипертензии (АГ), но и активации сердечно-сосудистого континуума [4][5][6].…”

Section: Introductionunclassified

Metabolic Disturbances in the Future Development and Progression of Arterial Hypertension in Young Men

Гордиенко¹,

Мирохина²,

Dydyshko³

et al. 2015

Klinicist

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Elevated 1-Hour Postload Plasma Glucose Levels Identify Subjects With Normal Glucose Tolerance but Impaired β-Cell Function, Insulin Resistance, and Worse Cardiovascular Risk Profile: The GENFIEV Study

Abstract: Among subjects with NGT, those with 1-hour OGTT glucose of >155 mg/dL showed lower insulin sensitivity, impaired β-cell function, and worse cardiovascular risk profile and therefore are at greater risk of developing T2DM and cardiovascular disease.

Cited by 105 publications

References 17 publications

Enhanced Predictive Capability of a 1-Hour Oral Glucose Tolerance Test: A Prospective Population-Based Cohort Study

Enhanced Predictive Capability of a 1-Hour Oral Glucose Tolerance Test: A Prospective Population-Based Cohort Study

Complications of Acute and Chronic Hyperglycemia

Metabolic Disturbances in the Future Development and Progression of Arterial Hypertension in Young Men

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