Significance of Oral Glucose Tolerance Tests in Non-alcoholic Fatty Liver Disease Patients with a Fasting Plasma Glucose Level of <126 mg/dL and HbA1c Level of ≤6.4% in Japan
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- Matsumoto Naoki
- Department of Health Management Center and Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Japan
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- Arase Yasuji
- Department of Health Management Center and Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Japan Department of Hepatology, Toranomon Hospital, Japan Department of Third Internal Medicine (Metabolism), University of Yamanashi, Japan
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- Kawamura Yusuke
- Department of Hepatology, Toranomon Hospital, Japan
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- Ohmoto-Sekine Miki
- Department of Health Management Center and Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Japan
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- Amakawa Kazuhisa
- Department of Health Management Center and Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Japan
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- Ogawa Kyoko
- Department of Health Management Center and Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Japan
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- Tsuji Hiroshi
- Department of Health Management Center and Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Japan
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- Dong Hsieh Shiun
- Department of Health Management Center and Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Japan
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- Hara Shigeko
- Department of Health Management Center and Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Japan
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- Akuta Norio
- Department of Hepatology, Toranomon Hospital, Japan
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- Suzuki Fumitaka
- Department of Hepatology, Toranomon Hospital, Japan
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- Suzuki Yoshiyuki
- Department of Hepatology, Toranomon Hospital, Japan
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- Ikeda Kenji
- Department of Hepatology, Toranomon Hospital, Japan
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- Kumada Hiromitsu
- Department of Hepatology, Toranomon Hospital, Japan
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- Kobayashi Tetsurou
- Department of Third Internal Medicine (Metabolism), University of Yamanashi, Japan
書誌事項
- タイトル別名
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- Significance of Oral Glucose Tolerance Tests in Non-alcoholic Fatty Liver Disease Patients with a Fasting Plasma Glucose Level of <126 mg/dL and HbA1c Level of ≤6.4% in Japan
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抄録
Objective The aim of this study was to clarify the indications for oral glucose tolerance tests (OGTT) in non-alcoholic fatty liver disease (NAFLD) subjects with a HbA1c level of ≤6.4%, fasting plasma glucose (FPG) level of <126 mg/dL and no history of diabetes.<br> Patients A total of 569 NAFLD subjects underwent 75-g OGTT. The plasma glucose and insulin levels were analyzed periodically for three hours during the OGTT examinations. Impaired fasting glucose (IFG) was defined as a plasma glucose level of ≥100 mg/dL to <126 mg/dL. Diabetes was defined as a two-hour post-load plasma glucose level of ≥200 mg/dL. Elevated insulin resistance was defined as a homeostasis model assessment-insulin resistance (HOMA-IR) of ≥2.5. Insulin secretory insufficiency was defined as an insulinogenic index of <0.4.<br> Results The prevalence of diabetes on the OGTT was 7.7% (44/569) among the NAFLD patients with an HbA1c level of ≤6.4%, FPG level of <126 mg/dL and no history of diabetes. A multivariate analysis showed that diabetes occurred more frequently when the subjects had IFG [odds ratio (OR) 5.13; 95% confidential interval (CI) 3.01-8.76; p<0.001] and an HbA1c level of 5.7-6.4% (OR 5.45; 95% CI 3.33-8.93; p<0.001). Of the NAFLD subjects with both IFG and an HbA1c level of 5.7-6.4%, 22.8% (28/123) exhibited a pattern of diabetes on OGTT. Regarding insulin dynamics, among the NAFLD subjects with both IFG and an HbA1c level of 5.7-6.4%, 25.2% (31/123) had elevated IR alone, 25.2% (31/123) had insulin secretory deficiency alone and 27.6% (34/123) had both elevated insulin resistance and insulin secretory deficiency.<br> Conclusion NAFLD subjects with IFG and an HbA1c level of 5.7-6.4% should undergo OGTT in order to determine whether they have diabetes and/or abnormal insulin dynamics.<br>
収録刊行物
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- Internal Medicine
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Internal Medicine 54 (8), 875-880, 2015
一般社団法人 日本内科学会