The insulin sensitivity in hypertensive patients with normal glucose tolerance (NGT), impaired glucose tolerance (IGT) and type 2 diabetes mellitus (DM) and the insulin resistance (IR) under the disorder of glucose metabolism and hypertension were studied. By glucose tolerance test and insulin release test, insulin sensitivity index (ISI) and the ratio of area under glucose tolerance curve (AUCG) to area under insulin release curve (AUCI) were calculated and analyzed. The results showed that ISI was decreased to varying degrees in the patients with hypertension, the mildest in the group of NGT with hypertension, followed by the group of IGT without hypertension, the group of IGT with hypertension and DM (P = 0). There was very significant difference in the ratio of AUCG/AUCI between the hypertensive patients with NGT and controls (P = 0). It was concluded that a significant IR existed during the development of IGT both in hypertension and nonhypertension. The increase of total insulin secretion (AUCI) was associated with nonhypertension simultaneously. IR of the hypertensive patients even existed in NGT and was worsened with the deterioration of glucose metabolism disorder, but the AUCI in the HT group changed slightly. A relative deficiency of insulin secretion or dysfunction of beta-cell of islet existed in IGT and DM of the hypertensive patients.
Diabetes Mellitus, Type 2/metabolism ; Glucose Intolerance/complications ; Glucose Intolerance/metabolism ; Hyperinsulinism/etiology ; Hyperinsulinism/metabolism ; Hypertension/complications ; Hypertension/*metabolism ; *Insulin Resistance

OBJECTIVETo investigate glycometabolism of patients with depression at first episode.

METHODSOral glucose tolerance test (OGTT) was performed in 100 patients with depression at first episode and 50 healthy subjects; the levels of fast blood plasma insulin were also measured.

RESULTThere were no statistically significant differences in fast blood plasma insulin levels and postprandial blood glucose levels at 0 h, 1 h and 3 h (P>0.05); the fasting blood glucose (FBS), postprandial blood glucose levels in 2 h and area under OGTT curve of depression patients were significantly higher than those of healthy controls. The frequency of impaired glucose tolerance (IGT) in depression patients was higher than that in controls (P<0.05).

CONCLUSIONDepression patients at the first episode are abnormal in glycometabolism, which may have clinical implication.

Adolescent ; Adult ; Aged ; Blood Glucose ; metabolism ; Case-Control Studies ; Depressive Disorder ; blood ; complications ; Female ; Glucose Intolerance ; complications ; Glucose Tolerance Test ; Humans ; Male ; Middle Aged ; Young Adult

The insulin sensitivity in hypertensive patients with normal glucose tolerance (NGT), impaired glucose tolerance (IGT) and type 2 diabetes mellitus (DM) and the insulin resistance (IR) under the disorder of glucose metabolism and hypertension were studied. By glucose tolerance test and insulin release test, insulin sensitivity index (ISI) and the ratio of area under glucose tolerance curve (AUCG) to area under insulin release curve (AUCI) were calculated and analyzed. The results showed that ISI was decreased to varying degrees in the patients with hypertension, the mildest in the group of NGT with hypertension, followed by the group of IGT without hypertension, the group of IGT with hypertension and DM (P = 0). There was very significant difference in the ratio of AUCG/AUCI between the hypertensive patients with NGT and controls (P = 0). It was concluded that a significant IR existed during the development of IGT both in hypertension and nonhypertension. The increase of total insulin secretion (AUCI) was associated with nonhypertension simultaneously. IR of the hypertensive patients even existed in NGT and was worsened with the deterioration of glucose metabolism disorder, but the AUCI in the HT group changed slightly. A relative deficiency of insulin secretion or dysfunction of beta-cell of islet existed in IGT and DM of the hypertensive patients.
Diabetes Mellitus, Type 2 ; metabolism ; Female ; Glucose Intolerance ; complications ; metabolism ; Humans ; Hyperinsulinism ; etiology ; metabolism ; Hypertension ; complications ; metabolism ; Insulin Resistance ; Male

OBJECTIVEAbnormal glucose metabolism during pregnancy can result in significant adverse outcomes for newborns. This study was designed to investigate the effect of different degrees of impaired glucose tolerance on newborns.

METHODSGlucose challenge test (GCT) and oral glucose tolerance test (OGTT) were performed in pregnant women at 24-28 weeks of gestation. Based on the results of the two tests, their newborn infants were classified into five groups: gestational diabetes mellitus (GDM, n=182), gestational impaired oral glucose tolerance [GIGT, subdividing into GIGT 1 h (n=57) and GIGT 2-3 h groups (n=156)based on the occurrence time of abnormal blood glucose after glucose load], GCT abnormal but OGTT normal (only GCT abnormal, n=38) and normal glucose tolerance (control, n=1 025). The perinatal outcomes were compared among the five groups.

RESULTSThe incidences of macrosomia, large for gestational age (LGA), small for gestational age (SGA), neonatal hypoglycemia and premature birth in the GIGT (1 h) group were significantly higher than those in the control group, but similar to those in the GDM group. The incidences of macrosomia, SGA, neonatal hypoglycemia and premature birth in the GIGT (2-3 h) and the only GCT abnormal groups significantly decreased as compared with those in the GDM group, and similar to those in the control group. GIGT (1 h ) group showed higher incidence of neonatal hypoglycemia and premature birth than the GIGT (2-3 h) and the only GCT abnormal groups.

CONCLUSIONSDifferent degrees of maternal impaired glucose tolerance have different effects on newborns. As maternal GDM, maternal GIGT (1 h) may increase the risk of macrosomia, LGA, SGA, neonatal hypoglycemia and premature birth.

Diabetes, Gestational ; metabolism ; Female ; Fetal Macrosomia ; etiology ; Glucose ; metabolism ; Glucose Intolerance ; complications ; Glucose Tolerance Test ; Humans ; Hypoglycemia ; etiology ; Infant, Newborn ; Male ; Pregnancy ; Premature Birth ; etiology ; Retrospective Studies

OBJECTIVE: To investigate the clinical significance of the determination of glycosylated hemoglobin (HbAlc) in gestational abnormal glucose metabolism. METHODS: The level of fasting plasma glucose (FPG) and HbAlc in 540 normal gravida and 387 pregnant women with abnormal glucose metabolism was determined. Glucose challenge test (GCT) with 50 g glucose was done to those whose level of FPG was normal and 75 g glucose tolerance test (OGTT) was done to those whose GCT was abnormal. The levels of HbAlc of all subjects were assessed. And all subjects were divided into some groups according to the levels of HbA1c, to investigate the relationship between the complication and the levels of HbAlc. RESULTS: The positive rate of HbAlc in abnormal glucose metabolism pregnant women was 20.9%. It was not sensitive if diagnosed only by this sign. Diagnosis by both FPG and this sign could solve this problem. The incidence of complication was increasing with the rise of HbA1c titre in the study group. CONCLUSION The determination of HbAlc is important in the screening, diagnosing and assessing the prognoses of the gestational abnormal glucose metabolism.
Adult ; Blood Glucose ; analysis ; Diabetes, Gestational ; blood ; Female ; Glucose Intolerance ; blood ; Glucose Tolerance Test ; Glycated Hemoglobin A ; analysis ; Humans ; Predictive Value of Tests ; Pregnancy ; Pregnancy Complications ; blood

OBJECTIVETo study the clinical features of liver disease patients with abnormal glucose metabolism.

METHODSLiver functions and levels of FPG, PPG, FINS, PINS, FCP, and PCP in 91 chronic hepatitis B patients with abnormal glucose metabolism (62 had liver cirrhosis) were analyzed.

RESULTS(1) The incidence of hepatogenic impaired glucose tolerance (IGT) and of diabetes mellitus (DM) in hepatitis B patients with liver cirrhosis (20.53%; 24.11%) were higher than those without cirrhosis (3.82%; 1.64%; P<0.05, P<0.01). (2) There were no diabetic symptoms among any of the hepatogenic IGT and DM patients. 12 of 19 chronic hepatitis B patients with primary DM and 6 of 12 hepatitis B associated liver cirrhosis patients with primary DM had diabetic symptoms. (3) The levels of FPG and PPG in chronic hepatitis B patients with hepatogenic IGT and DM were lower than those in the patients with primary DM (P<0.05), but the levels of PINS and PCP in chronic hepatitis B patients with hepatogenic IGT and DM were higher than those in the patients with primary DM (P<0.05). (4) There were no differences in the levels of FPG and PPG between the hepatitis B associated liver cirrhosis patients with hepatogenic DM and those with primary DM (P<0.05). The levels of FINS, PINS, FCP, and PCP were higher in the hepatitis B associated liver cirrhosis patients with hepatogenic DM than those in the hepatitis B associated liver cirrhosis patients with primary DM (P<0.05). The levels of FPG and PPG in the hepatogenic DM patients were higher than those in the hepatogenic IGT patients (P<0.05), but their levels of FINS, PINS, FCP and PCP were lower than those in the hepatogenic IGT patients (P<0.05, P<0.01).

CONCLUSIONHepatogenic IGT and DM are always secondary in severe liver cirrhosis patients, who always showed no diabetic symptoms. The chronic hepatitis B patients with hepatogenic DM had increased insulin secretion, while the hepatitis B associated liver cirrhosis patients with hepatogenic DM had decreased insulin secretion.

Blood Glucose ; metabolism ; Diabetes Mellitus ; epidemiology ; etiology ; metabolism ; Female ; Glucose Intolerance ; Hepatitis B, Chronic ; complications ; metabolism ; Humans ; Liver Cirrhosis ; complications ; metabolism ; Male

BACKGROUNDThe concentration of serum fructosamine is correlated with plasma glucose level. The aim of this study was to determine whether the level of serum fructosamine can be diagnostic for abnormal glucose tolerance in pregnant women.

METHODSSerum samples were collected from 161 pregnant women between November 2004 and April 2005. The women were divided into three groups according to the gestational age (16 - 20 weeks group, 56 patients; 28 - 34 weeks group, 72; and 37 - 41 weeks group, 33). Each group was subdivided into normal and abnormal glucose tolerance subgroups. The levels of serum fructosamine were measured. Differences among the groups were assessed by ANOVA and Student-Newman-Keuls test. Correlations between the level of fructosamine and other variables including the results of glucose challenge test (GCT), oral glucose tolerance test (OGTT), and glycosylated hemoglobin (HbA1c) test, and infant's birth weight were analyzed by Pearson correlation.

RESULTSThe level of serum fructosamine decreased with gestational age [(223.25 +/- 48.90) micromol/L, (98.44 +/- 29.57) micromol/L, and (53.99 +/- 29.94) micromol/L, respectively. P < 0.05]. It was higher in women with abnormal glucose tolerance than that in women with normal glucose tolerance, however, the difference reached statistical significance only in the 28 - 34 weeks group (P < 0.05). In this group, the level of serum fructosamine correlated positively with the GCT result (r = 0.28, P < 0.05). No correlation was found between fructosamine level and OGTT result, HbA1c level, or neonatal weight.

CONCLUSIONSFructosamine can be used to monitor the glucose level of pregnant women with abnormal glucose tolerance, and to identify the patients at high risk of abnormal glucose tolerance, but can not be used to predict gestational diabetes mellitus (GDM) in early stage of pregnancy.

Adult ; Case-Control Studies ; Diabetes, Gestational ; blood ; Female ; Fructosamine ; blood ; Glucose Intolerance ; blood ; Glucose Tolerance Test ; Humans ; Pregnancy ; Pregnancy Complications ; blood

Objective: To investigate the prevalence of erectile dysfunction (ED) in men with pre-diabetes. METHODS: This study included 500 men with impaired fasting glycaemia (IFG), 500 with impaired glucose tolerance (IGT), and another 500 with normal blood glucose (NBG), all from Lanzhou. We conducted a questionnaire investigation among the subjects using the International Index of Erectile Dysfunction 5 (IIEF-5). RESULTS: The prevalence rates of ED in the IFG, IGT, and NBG groups were 14.8%, 29.2%, and 33.2%, respectively. After controlling for age, nationality, occupation, education, income, obesity, and blood pressure, the incidence rate was markedly higher in the IFG and IGT than in the NBG group (29.2% and 33.2% vs 14.8%, P <0.05), but showed no statistically significant difference between the IFG and IGT groups (P >0.05). CONCLUSIONS The prevalence of ED is higher in men with pre-diabetes than in those with normal blood glucose in Lanzhou.
Blood Glucose ; Blood Pressure ; China ; epidemiology ; Diabetes Mellitus ; Erectile Dysfunction ; epidemiology ; etiology ; Ethnic Groups ; Glucose Intolerance ; epidemiology ; Humans ; Male ; Obesity ; epidemiology ; Prediabetic State ; complications ; Prevalence ; Surveys and Questionnaires

OBJECTIVES: The pathogenesis of nonalcoholic fatty liver in non-obese persons is poorly understood. We aimed to elucidate whether hyperinsulinemia and glucose intolerance are associated with development of fatty liver in patients with normal body weight. METHODS: Forty-seven patients with fatty liver were divided into non-obese (n = 25) and obese groups (n = 22) according to age adjusted body mass index. Inclusion criteria were as follows: (1) elevated transaminase levels during more than 3 months of follow up period, (2) no detectable HBsAg or anti-HCV in the serum, (3) alcohol consumption less than 40 gm/week, (4) no use of potential hepatotoxic drugs within 3 months and (4) sonographic evidence of fatty liver(moderate to severe degree). Baseline insulin levels and oral glucose tolerance test using 75gm of glucose were performed and the results were compared in each group of patients. RESULTS: Mean baseline insulin levels were elevated in both groups above the reference value, 9.3 +/- 3.5 microU/L in non-obese group and 9.9 +/- 3.5 microU/L in obese group (p = 0.26). Seventeen of non-obese patients (68%) had elevated basal insulin level and 16 of obese patients (73%) had elevated basal insulin level (p = 0.39). In oral glucose tolerance test, there was no difference in glucose level between non-obese and obese groups from O minute to 180 minutes (p > 0.05). Eleven patients from the non-obese group (44%) and 8 patients from the obese group (36%) had either impaired glucose tolerance or diabetes (p = 0.29). CONCLUSION: Our data suggest that hyperinsulinemia and glucose intolerance may play a role in the pathogenesis of fatty liver in patients with normal body weight as well as in patients with obesity.
Adult ; Body Weight ; Fatty Liver/pathology ; Fatty Liver/etiology* ; Fatty Liver/blood ; Female ; Glucose Intolerance/complications* ; Human ; Insulin/blood* ; Insulin Resistance ; Male ; Middle Age ; Obesity/complications

OBJECTIVETo study the role of baseline risk factors in predicting the onset of diabetes among essential hypertensive patients with metabolic syndrome (MS) and to evaluate an ideal therapeutic regime that could reduce the risk factors and risk of onset of diabetes.

METHODSA randomized parallel clinical trial in essential hypertensive patients of grade 1 or 2 was conducted. Two of the three components (1) increased waist circumference and/or BMI; (2) increased triglycerides (TG) and/or decreased high-density lipoprotein cholesterol; (3) impaired glucose tolerance (IGT) were present define the MS. The three intervention therapy groups were: indapamide + fosinopril (I + F, n = 151); atenolol + nitrendipine (A + N, n = 160); atenolol + nitrendipine + metformin (A + N + M, n = 152). Each case was followed-up monthly and the dosage of medicine taken be adjusted according to their BP level. The plasma glucose during fasting and two hours after taking 75 g glucose orally was also measured every six months. The new onset of diabetes was diagnosed according to the criteria. OGTT, insulin release test, lipid analysis, body weight and waist circumference were measured again at the last follow-up.

RESULTS(1) The lowering of BP was similar among the three groups (P > 0.05). 23 new diabetes onsets occurred, being 10 in group I + F and 8 in group A + N and 5 in group A + N + M, respectively (P > 0.05); (2) Proportions of patients' risk factors decreased significantly in group A + N or A + N + M, e.g. the proportions of high TG in each group reduced by 14.7% and 9.3% respectively (P < 0.05), the central fat distribution reduced by 16.7% and 15.9% respectively (P < 0.05) and the IGT reduced by 6.6% and 29.6% respectively (P < 0.05). However no changes were found in group I + F; (3) After 1 year and 5 months' follow-up, the proportions of main risk factors (high TG, central fat distribution and IGT) in the three groups were 91%, 96%, 83% and 90%, 88%, 47%, respectively. The difference of IGT was significant between two groups (P < 0.01) and the proportions of having three risk factors were 70% and 31% in the two groups (P < 0.01); (4) I + F group was better than A + N group in reduction of TG and central fat distribution. And A + N + M group improved in all risk factors.

CONCLUSIONSIGT alone or combined with increased TG plus abdominal obesity are the most important risk factors in predicting a new onset of diabetes among essential hypertensive patients with MS. Metformin in combination with atenolol plus nitrendipine can significantly prevent the onset of diabetes as well as improve patients' metabolic abnormality.

Adult ; Diabetes Mellitus, Type 2 ; prevention & control ; Drug Therapy, Combination ; Female ; Glucose Intolerance ; Humans ; Hypertension ; complications ; drug therapy ; Male ; Metabolic Syndrome ; complications ; drug therapy ; Middle Aged ; Risk Factors