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題名 | Glucose and Non-glucose Predictors of Future Onset of Type 2 Diabetes in Newly Diagnosed Essential Hypertensives=原發性高血壓病患未來發生第二型糖尿病之血糖及非血糖預測因子 |
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作者 | 馮文楷; 黃金洲; 呂信邦; 吳道正; 林幸榮; 陳肇文; Fong, Man-cai; Huang, Chin-chou; Leu, Hsin-bang; Wu, Tao-cheng; Lin, Shing-jong; Chen, Jaw-wen; |
期刊 | Journal of the Chinese Medical Association |
出版日期 | 20091100 |
卷期 | 72:11 2009.11[民98.11] |
頁次 | 頁564-572+CA106 |
分類號 | 415.6681 |
語文 | eng、eng |
關鍵詞 | 血壓; 糖尿病; 日夜血壓變化; 空腹血糖; 肝功能; Blood pressure; Diabetes mellitus; Diurnal change; Fasting glucose; Liver function; |
英文摘要 | Background: Baseline fasting plasma glucose (FPG) level predicts the onset of type 2 diabetes mellitus (DM). Other predictors have been less investigated. This study aimed to investigate non-glucose predictors together with FPG for future onset of type 2 DM in fresh essential hypertensives. Methods: Consecutive nondiabetic patients with newly diagnosed essential hypertension were prospectively evaluated for diurnal blood pressure (BP) change by ambulatory BP monitoring, vascular endothelial function by plethysmography, and biomarkers by blood biochemistry. They were then given guideline-based treatment and followed-up regularly for more than 5 years. Results: During a mean follow-up period of 5.9 years, 6 of the 106 study patients developed DM. Baseline FPG, alanine aminotransferase (ALT) level, and day-night difference in diastolic BP were related to future onset of DM. FPG > 5.8 mmol/L (p = 0.034) and ALT > 31U/L (p = 0.048) independently and day-night difference in diastolic BP ≤ 2.9% potentially predicted new-onset DM (p = 0.089). Simultaneously having at least 2 of the indicators mentioned above at baseline is predictive of new-onset DM. Parameters of reactive hyperemia by plethysmography were not relevant. Conclusion: In addition to FPG, baseline serum ALT level independently and diurnal diastolic BP changes potentially predicted future onset of type 2 DM in newly diagnosed hypertensives. Both glucose and non-glucose indicators could be examined together for early risk stratification of future DM. |
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