http://tw.news.yahoo.com/article/url/d/ ... 1l2kx.html
更新日期:2009/06/11 11:16 楊舒婷
【記者楊舒婷綜合報導】看血糖、胰島素變化，就能知道三年後會不會得第二型糖尿病！科學家發現，體內血糖、胰島素等化學變化，似乎與病發時間有對應關係；透過檢測，將有效及早篩檢糖尿病之高風險群，進而延遲症狀出現的時間。
倫敦大學學院的這份報告發表於著名《Lancet》期刊。研究團隊追蹤6538名英國民眾長達10年，檢查受試者的血糖指數、胰島素敏感度、分泌胰島素的beta細胞如何隨時間變化。
10年期間，罹患第二型糖尿病有505位。科學家發現，這些糖尿病患者於發病前三年，體內即有大幅度飯前血糖、飯後血糖累積的情形，胰島素敏感度則在前五年就開始大幅降低。為了平衡不斷升高的血糖指數，在前三、四年，beta細胞會增強功能，但之後就會減弱功效。
研究人員相信這項研究成果，能發展出更準確預測第二型糖尿病患者的風險模組。計畫主持人亞當‧他巴克表示：「若在一般認知的前糖尿病時期之前，就趁早介入，有機會有效延遲糖尿病病情發展。」
不過，糖尿病專家大衛‧馬修與強納森‧李維持保留態度。《Lancet》期刊同步刊登了這幾位專家的說法。他認為光憑敏感度等作預測，推論過於薄弱，未來仍需更多研究。
然而無論如何，如英國心臟基金會茱蒂‧歐蘇利文所言：「這份報告再一次告訴我們，更審慎、頻繁的作定期檢測，確實有助於預防或延遲糖尿病的發生。」
得糖尿病 三年前即可知
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braveheart8149
- V1
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- 註冊時間: 週六 5月 31, 2008 2:57 pm
- 來自: 地深之源
Re: 得糖尿病 三年前即可知
http://www.thelancet.com/journals/lance ... X/fulltext
Trajectories of glycaemia, insulin sensitivity, and insulin secretion before diagnosis of type 2 diabetes: an analysis from the Whitehall II study
Original TextDr Adam G Tabák MD a b , Markus Jokela PhD a c, Tasnime N Akbaraly PhD a d, Eric J Brunner PhD a, Prof Mika Kivimäki PhD a e ‡, Daniel R Witte MD a f ‡
Summary
Background
Little is known about the timing of changes in glucose metabolism before occurrence of type 2 diabetes. We aimed to characterise trajectories of fasting and postload glucose, insulin sensitivity, and insulin secretion in individuals who develop type 2 diabetes.
Methods
We analysed data from our prospective occupational cohort study (Whitehall II study) of 6538 (71% male and 91% white) British civil servants without diabetes mellitus at baseline. During a median follow-up period of 9·7 years, 505 diabetes cases were diagnosed (49·1% on the basis of oral glucose tolerance test). We assessed retrospective trajectories of fasting and 2-h postload glucose, homoeostasis model assessment (HOMA) insulin sensitivity, and HOMA β-cell function from up to 13 years before diabetes diagnosis (diabetic group) or at the end of follow-up (non-diabetics).
Findings
Multilevel models adjusted for age, sex, and ethnic origin confirmed that all metabolic measures followed linear trends in the group of non-diabetics (10 989 measurements), except for insulin secretion that did not change during follow-up. In the diabetic group (801 measurements), a linear increase in fasting glucose was followed by a steep quadratic increase (from 5·79 mmol/L to 7·40 mmol/L) starting 3 years before diagnosis of diabetes. 2-h postload glucose showed a rapid increase starting 3 years before diagnosis (from 7·60 mmol/L to 11·90 mmol/L), and HOMA insulin sensitivity decreased steeply during the 5 years before diagnosis (to 86·7%). HOMA β-cell function increased between years 4 and 3 before diagnosis (from 85·0% to 92·6%) and then decreased until diagnosis (to 62·4%).
Interpretation
In this study, we show changes in glucose concentrations, insulin sensitivity, and insulin secretion as much as 3—6 years before diagnosis of diabetes. The description of biomarker trajectories leading to diabetes diagnosis could contribute to more-accurate risk prediction models that use repeated measures available for patients through regular check-ups.
Funding
Medical Research Council (UK); Economic and Social Research Council (UK); British Heart Foundation (UK); Health and Safety Executive (UK); Department of Health (UK); National Institute of Health (USA); Agency for Health Care Policy Research (USA); the John D and Catherine T MacArthur Foundation (USA); and Academy of Finland (Finland).
ps.需要全文PDF檔，可ＰＭ偶...僅供學術討論...
Trajectories of glycaemia, insulin sensitivity, and insulin secretion before diagnosis of type 2 diabetes: an analysis from the Whitehall II study
Original TextDr Adam G Tabák MD a b , Markus Jokela PhD a c, Tasnime N Akbaraly PhD a d, Eric J Brunner PhD a, Prof Mika Kivimäki PhD a e ‡, Daniel R Witte MD a f ‡
Summary
Background
Little is known about the timing of changes in glucose metabolism before occurrence of type 2 diabetes. We aimed to characterise trajectories of fasting and postload glucose, insulin sensitivity, and insulin secretion in individuals who develop type 2 diabetes.
Methods
We analysed data from our prospective occupational cohort study (Whitehall II study) of 6538 (71% male and 91% white) British civil servants without diabetes mellitus at baseline. During a median follow-up period of 9·7 years, 505 diabetes cases were diagnosed (49·1% on the basis of oral glucose tolerance test). We assessed retrospective trajectories of fasting and 2-h postload glucose, homoeostasis model assessment (HOMA) insulin sensitivity, and HOMA β-cell function from up to 13 years before diabetes diagnosis (diabetic group) or at the end of follow-up (non-diabetics).
Findings
Multilevel models adjusted for age, sex, and ethnic origin confirmed that all metabolic measures followed linear trends in the group of non-diabetics (10 989 measurements), except for insulin secretion that did not change during follow-up. In the diabetic group (801 measurements), a linear increase in fasting glucose was followed by a steep quadratic increase (from 5·79 mmol/L to 7·40 mmol/L) starting 3 years before diagnosis of diabetes. 2-h postload glucose showed a rapid increase starting 3 years before diagnosis (from 7·60 mmol/L to 11·90 mmol/L), and HOMA insulin sensitivity decreased steeply during the 5 years before diagnosis (to 86·7%). HOMA β-cell function increased between years 4 and 3 before diagnosis (from 85·0% to 92·6%) and then decreased until diagnosis (to 62·4%).
Interpretation
In this study, we show changes in glucose concentrations, insulin sensitivity, and insulin secretion as much as 3—6 years before diagnosis of diabetes. The description of biomarker trajectories leading to diabetes diagnosis could contribute to more-accurate risk prediction models that use repeated measures available for patients through regular check-ups.
Funding
Medical Research Council (UK); Economic and Social Research Council (UK); British Heart Foundation (UK); Health and Safety Executive (UK); Department of Health (UK); National Institute of Health (USA); Agency for Health Care Policy Research (USA); the John D and Catherine T MacArthur Foundation (USA); and Academy of Finland (Finland).
ps.需要全文PDF檔，可ＰＭ偶...僅供學術討論...
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SIMON
- 部長級
- 文章: 6661
- 註冊時間: 週三 8月 09, 2006 11:29 am
Re: 得糖尿病 三年前即可知
這樣的檢查大都NORMAL,健保一定被砍.braveheart8149 寫:http://tw.news.yahoo.com/article/url/d/ ... 1l2kx.html
更新日期:2009/06/11 11:16 楊舒婷
【記者楊舒婷綜合報導】看血糖、胰島素變化，就能知道三年後會不會得第二型糖尿病！科學家發現，體內血糖、胰島素等化學變化，似乎與病發時間有對應關係；透過檢測，將有效及早篩檢糖尿病之高風險群，進而延遲症狀出現的時間。
倫敦大學學院的這份報告發表於著名《Lancet》期刊。研究團隊追蹤6538名英國民眾長達10年，檢查受試者的血糖指數、胰島素敏感度、分泌胰島素的beta細胞如何隨時間變化。
10年期間，罹患第二型糖尿病有505位。科學家發現，這些糖尿病患者於發病前三年，體內即有大幅度飯前血糖、飯後血糖累積的情形，胰島素敏感度則在前五年就開始大幅降低。為了平衡不斷升高的血糖指數，在前三、四年，beta細胞會增強功能，但之後就會減弱功效。
研究人員相信這項研究成果，能發展出更準確預測第二型糖尿病患者的風險模組。計畫主持人亞當‧他巴克表示：「若在一般認知的前糖尿病時期之前，就趁早介入，有機會有效延遲糖尿病病情發展。」
不過，糖尿病專家大衛‧馬修與強納森‧李維持保留態度。《Lancet》期刊同步刊登了這幾位專家的說法。他認為光憑敏感度等作預測，推論過於薄弱，未來仍需更多研究。
然而無論如何，如英國心臟基金會茱蒂‧歐蘇利文所言：「這份報告再一次告訴我們，更審慎、頻繁的作定期檢測，確實有助於預防或延遲糖尿病的發生。」
年年是好年，
不被病人嫌，
看病不被醃，
快樂勝神仙！
不被病人嫌，
看病不被醃，
快樂勝神仙！
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poki
- V4
- 文章: 4516
- 註冊時間: 週一 11月 13, 2006 5:24 am
Re: 得糖尿病 三年前即可知
糖尿病專家的評語太含蓄, 太有禮貌了,
1. HOMA 間接方法測胰島素敏感性, 血糖就是其中一個重要的參數,
與血糖相關性密切理所當然, 沒甚麼好說的了
2. 所謂的beta-cell功能增強(胰島素分泌量增加)現象,幾十年前課本就提到了,
也提到此時實際上beta-cell 功能卻是減弱的, 這點我印象很深, 因為那時我當intern,
問V這個問題, V回答說:如果beta-cell 功能正常, 就會分泌更大量胰島素, 使血糖下降後
恢復正常胰島素分泌, 不會ㄍㄧㄥ在那邊, 血糖卻降不下來
3. 胰島素敏感性降低的人, 在總人口25%以上, 但發生糖尿病的約4%(調查結果差異大),
用這個東西預測糖尿病, 槓龜的機會超級大, 幾乎所有文章都說不可行, 這篇卻說得像是很有希望
1. HOMA 間接方法測胰島素敏感性, 血糖就是其中一個重要的參數,
與血糖相關性密切理所當然, 沒甚麼好說的了
2. 所謂的beta-cell功能增強(胰島素分泌量增加)現象,幾十年前課本就提到了,
也提到此時實際上beta-cell 功能卻是減弱的, 這點我印象很深, 因為那時我當intern,
問V這個問題, V回答說:如果beta-cell 功能正常, 就會分泌更大量胰島素, 使血糖下降後
恢復正常胰島素分泌, 不會ㄍㄧㄥ在那邊, 血糖卻降不下來
3. 胰島素敏感性降低的人, 在總人口25%以上, 但發生糖尿病的約4%(調查結果差異大),
用這個東西預測糖尿病, 槓龜的機會超級大, 幾乎所有文章都說不可行, 這篇卻說得像是很有希望