Turkiye Klinikleri Journal of Medical Sciences

.: ORIGINAL RESEARCH
Normal Glukoz Toleransına Sahip Çocuklarda OGTT'de 1. Saat Plazma Glukoz Yüksekliği Önemli Bir Parametre midir?
Is the 1st Hour Plasma Glucose Level in OGTT an Important Parameter in Children with Normal Glucose Tolerance?
Nursel MURATOĞLU ŞAHİNa, Aslıhan ARASLI YILMAZa, Zehra AYCANa,b
aSağlık Bilimleri Üniversitesi Ankara Dr. Sami Ulus Kadın Doğum, Çocuk Sağlığı ve Hastalıkları Eğitim ve Araştırma Hastanesi, Çocuk Endokrinolojisi Kliniği, Ankara, TÜRKİYE
bAnkara Üniversitesi Tıp Fakültesi, Çocuk Endokrinolojisi BD, Ankara, TÜRKİYE
Turkiye Klinikleri J Med Sci. 2020;40(1):1-9
doi: 10.5336/medsci.2019-71852
Article Language: TR
Full Text
ÖZET
 Amaç: Erişkinlerde oral glukoz tolerans testi (OGTT)nde 1. saat plazma glukoz düzeyinin ≥155 mg/dL olması diyabet, dislipidemi, kardiyovasküler hastalık ve nonalkolik yağlı karaciğer hastalığı riskini artırmaktadır. Çocuklarda yapılan araştırmalar sınırlı olup, çalışmamızda normal glukoz toleransı (NGT)na sahip çocuklarda 1. Saat plazma glukoz yüksekliğinin metabolik parametrelerle ilişkisi araştırıldı. Gereç ve Yöntemler: Yaşları 9-18 yıl arasındaki 143 fazla kilolu/ obez çocuk ve adölesanın verileri NGT (açlık plazma glukozu <100 mg/dL ve OGTT'de 2. saat plazma glukozu <140 mg/dL) retrospektif incelendi. Birinci saat plazma glukoz düzeyi <155 mg/dL olanlar Grup 1, ≥155 mg/dL olanlar Grup 2 olarak ayrıldı. Bulgular: Birinci saat plazma glukozu; trigliserid, ALT, HbA1c ve HOMA-IR ile pozitif, HDL ile negatif koreleydi (p<0,05). Grup 2'de erkeklerin oranı (%53,1), Grup 1'e göre (%30,6) daha fazla idi (p:0,019). Grup 2'de sistolik, diyastolik kan basıncı, HbA1c, açlık insülin, trigliserid, ALT düzeyi daha yüksek, HDL düzeyi daha düşüktü (p<0,05). Grup 2'nin HOMA-IR değeri daha yüksekken; tüm vücut insülin duyarlılık indeksi (WBISI), dispozisyon indeksi (DI) değerleri daha düşüktü (p<0,05). Grup 2'de nonalkolik yağlı karaciğer hastalığı daha sıktı (p:0,001). Çoklu regresyon analizi ile değerlendirildiğinde OGTT 1. saat plazma glukoz düzeyi ≥155 mg/dL olma riski; evre 1 nonalkolik yağlı karaciğer hastalığı olanlarda olmayanlara oranla 1,832 kat daha yüksekti (p:0,003). Sonuç: Çalışmamız, çocuk ve adölesanlarda 1. saat plazma glukoz yüksekliği ile nonalkolik yağlı karaciğer hastalığı arasında ilişki saptanan ilk çalışmadır. Normal açlık glukozu ve NGT durumunda bile 1. saat plazma glukoz yüksekliğinin kötü metabolik profille ilişkili saptanmış olması, çocuk ve adölesanlarda 1. saat plazma glukoz düzeyinin insülin direnci, prediyabet ve nonalkolik yağlı karaciğer hastalığı için önemli ve erken bir belirteç olduğunu göstermektedir.

Anahtar Kelimeler: Glukoz tolerans testi; çocuk; adolesan; diabetes mellitus, tip 2; non alkolik yağlı karaciğer hastalığı
ABSTRACT
 Objective: One-hour plasma glucose level ≥155 mg/dL in the oral glucose tolerance test (OGTT) in adults increases the risk of diabetes, dyslipidemia, cardiovascular disease and non-alcoholic fatty liver disease. Studies in children are limited and in our study, the relationship between the one-hour plasma glucose elevation and metabolic parameters was investigated in children with normal glucose tolerance (NGT). Material and Methods: 143 overweight/obese children who were 9-18 years old with NGT result (fasting plasma glucose <100 mg/dL and 2nd hour glucose concentration <140 mg/dL in OGTT) were evaluated retrospectively. The group with 1st hour glucose concentration of <155 mg/dL was grouped Group 1 and the group with 1st hour glucose concentration of ≥155 mg/dL was grouped Group 2. Results: One-hour glucose level was positively correlated with triglyceride, ALT, HbA1c, HOMA-IR and negatively correlated with HDL (p<0.05). The ratio of males in Group 2 (53.1%) was more frequent than in Group 1 (30.6%) (p:0.019). In Group 2 systolic, diastolic blood pressure, HbA1c, fasting insulin, triglyceride, ALT were significantly higher, and HDL levels were lower (p<0.05). In Group 2 HOMA-IR level was higher, whole-body insulin sensitivity index (WBISI) and disposition index (DI) were significantly lower (p<0.05). In Group 2 the ratio of non-alcoholic fatty liver disease was more frequent (p: 0.001). Conclusion: Our study is the first study to found the relationship between level of 1st hour plasma glucose and non-alcoholic fatty liver disease in children and adolescents. Onehour plasma glucose level in children and adolescents is an important and early marker of insulin resistance, prediabetes and non-alcoholic fatty liver disease.

Keywords: Glucose tolerance test; children; adolescent; diabetes mellitus, type 2; non-alcoholic fatty liver disease
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Turkish Law will be applied in practicing, interpreting the hereby "Terms of Use" and managing the emerging legal relationships within this "Terms of Use" in case of finding element of foreignness, except for the rules of Turkish conflict of laws. Ankara Courts and Enforcement Offices are entitled in any controversy happened or may happen due to hereby contract.

9. CLOSING AND AGREEMENT

Hereby "Terms of Use" come into force when announced in the "SITE" by "Turkiye Klinikleri". The users are regarded to agree to hereby contract terms by using the "SITE". "Turkiye Klinikleri" may change the contract terms and the changes will be come into force by specifying the version number and the date of change on time it is published in the "SITE".

 

30.03.2014

Privacy Policy

We recommend you to read the terms of use below before you visit our website. In case you agree these terms, following our rules will be to your favor. Please read our Terms of Use thoroughly.

www.turkiyeklinikleri.com website belongs to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. and is designed in order to inform physicians in the field of health

www.turkiyeklinikleri.com cannot reach to user’s identity, address, service providers or other information. The users may send this information to the website through forms if they would like to. However, www.turkiyeklinikleri.com may collect your hardware and software information. The information consists of your IP address, browser type, operating system, domain name, access time, and related websites. www.turkiyeklinikleri.com cannot sell the provided user information (your name, e-mail address, home and work address, phone number) to the third parties, publish it publicly, or keep it in the website. Gathered information has a directing feature to be a source for the website’s visitor profile, reporting and promotion of the services.

www.turkiyeklinikleri.com uses the taken information:

-To enhance, improve and maintain the quality of the website

-To generate visitor’s profile and statistical data

-To determine the tendency of the visitors on using our website

-To send print publications/correspondences

-To send press releases or notifications through e-mail

-To generate a list for an event or competition

By using www.turkiyeklinikleri.com you are considered to agree that;

-Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. cannot be hold responsible for any user’s illegal and immoral behavior,

-Terms of use may change from time to time,

-It is not responsible for other websites’ contents it cannot control or the harms they may cause although it uses the connection they provided.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. may block the website to users in the following events:

-Information with wrong, incomplete, deceiving or immoral expressions is recorded to the website,

-Proclamation, advertisement, announcement, libelous expressions are used against natural person or legal identity,

-During various attacks to the website,

-Disruption of the website because of a virus.

Written, visual and audible materials of the website, including the code and the software are under protection by legal legislation.

Without the written consent of Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. the information on the website cannot be downloaded, changed, reproduced, copied, republished, posted or distributed.

All rights of the software and the design of the website belong to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. will be pleased to hear your comments about our terms of use. Please share the subjects you think may enrich our website or if there is any problem regarding our website.

info@turkiyeklinikleri.com