Resumen de Características clínicas y metabólicas de los estados de intolerancia a la glucosa y glicemia de ayuno alteradas
Antonio Arteaga, Felipe Pollak, Leonor Robres, Nicolás Velasco
Background: Subjects with glucose intolerance or high fasting glucose levels have a higher cardiovascular rísk and frequently become diabetic. Aim: To assess clinical and metabolic characteristics of patients with glucose intolerance or high fasting glucose levels. Material and methods: Fasting and post glucose load serum glucose and insulin levels were measured in 1404 people, aged 42,0 ± 14,2 years (81% women) with high diabetic rísk. We categorízed subjects in different alterations of blood glucose, according to 2006 Amerícan Diabetes Association categoríes. Insulin resistance (RI), insulin secretion (B %) and insulin disposition (ID), were calculated using fasting blood glucose and insulin levels, using the homeostasis model assessment (HOMA I and II). Results: Sixty percent of studied subjects had first grade relatives with diabetes mellitus and 1097 (78%) were categorízed as normal (N), 45 (3%) as Diabetes Mellitus (DM), 161 (11%) as high fasting glucose levels (GAA) and 103 (7%) as glucose intolerant (ITG). Fifty three of the 106 subjects with GAA (50%), were also glucose intolerant. Subjects with GAA had similar insulin sensitivity and lower B cell function than N (insulin disposition 58 ± 12 and 111 ± 32%, respectively p <0.01). ITG had less insulin sensitivity than N (HOMA-IR 2.6 ± 1.50 ± and 2.0 ± 1.30, respectively) and only a mild decrease in B cell function (insulin disposition 96 ± 26 and 111 ± 32% respectively, p < 0.01). Patients GAA plus ITG had similar alterations than those with DM (HOMA-IR 3.8 ± 2.2 and 4.4 ± 3.7respectively; insulin disposition 57 ± 10 and 56.0 ± 26% respectively. Conclusions: Patients with higher fasting glucose levels behave differently from those with glucose intolerance. High fasting glucose levels are highly prevalent in subjects with high rísk of DM and must be considered as rísk indicator in preventive programs for diabetes mellitus.
