对急性 COVID-19 感染中出现血糖异常的 COVID-19 幸存者的血糖状况和 C 肽水平进行为期 1 年的前瞻性随访。

IF 6.8 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Diabetes & Metabolism Journal Pub Date : 2024-07-01 Epub Date: 2024-03-11 DOI:10.4093/dmj.2023.0175
David Tak Wai Lui, Chi Ho Lee, Ying Wong, Carol Ho Yi Fong, Kimberly Hang Tsoi, Yu Cho Woo, Kathryn Choon Beng Tan
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引用次数: 0

摘要

背景:我们评估了2019年冠状病毒病(COVID-19)急性COVID-19血糖异常幸存者1年来的血糖变化情况:2020年9月至10月期间,从一家主要的COVID-19治疗中心招募了急性COVID-19血糖异常(定义为糖化血红蛋白[HbA1c] 5.7%至6.4%或随机血糖≥10.0 mmol/L)的COVID-19幸存者。从社区招募匹配的非 COVID 对照组。在基线(急性 COVID-19 后 6 周)和急性 COVID-19 后 1 年进行 75 克口服葡萄糖耐量试验 (OGTT),并测量 HbA1c、胰岛素和 C 肽。血糖状况的恶化是指从正常血糖恶化为糖尿病前期/糖尿病,或从糖尿病前期恶化为糖尿病:结果:共招募了52名COVID-19幸存者。与非 COVID 对照组相比,他们的 C 肽更高(P< 0.001),胰岛素抵抗稳态模型评估值也呈上升趋势(P=0.065)。43名COVID-19幸存者参加了为期1年的复查。HbA1c从5.5%±0.3%升至5.7%±0.2%(PC结论:在急性 COVID-19 中出现血糖异常的受试者具有胰岛素抵抗的特征。在一年内,四分之一的受试者血糖状况有所恶化,尤其是那些 COVID-19 更为严重的受试者。重要的是,胰岛素分泌能力没有明显下降。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A Prospective 1-Year Follow-up of Glycemic Status and C-Peptide Levels of COVID-19 Survivors with Dysglycemia in Acute COVID-19 Infection.

Backgruound: We evaluated changes in glycemic status, over 1 year, of coronavirus disease 2019 (COVID-19) survivors with dysglycemia in acute COVID-19.

Methods: COVID-19 survivors who had dysglycemia (defined by glycosylated hemoglobin [HbA1c] 5.7% to 6.4% or random glucose ≥10.0 mmol/L) in acute COVID-19 were recruited from a major COVID-19 treatment center from September to October 2020. Matched non-COVID controls were recruited from community. The 75-g oral glucose tolerance test (OGTT) were performed at baseline (6 weeks after acute COVID-19) and 1 year after acute COVID-19, with HbA1c, insulin and C-peptide measurements. Progression in glycemic status was defined by progression from normoglycemia to prediabetes/diabetes, or prediabetes to diabetes.

Results: Fifty-two COVID-19 survivors were recruited. Compared with non-COVID controls, they had higher C-peptide (P< 0.001) and trend towards higher homeostasis model assessment of insulin resistance (P=0.065). Forty-three COVID-19 survivors attended 1-year reassessment. HbA1c increased from 5.5%±0.3% to 5.7%±0.2% (P<0.001), with increases in glucose on OGTT at fasting (P=0.089), 30-minute (P=0.126), 1-hour (P=0.014), and 2-hour (P=0.165). At baseline, 19 subjects had normoglycemia, 23 had prediabetes, and one had diabetes. Over 1 year, 10 subjects (23.8%; of 42 non-diabetes subjects at baseline) had progression in glycemic status. C-peptide levels remained unchanged (P=0.835). Matsuda index decreased (P=0.007) and there was a trend of body mass index increase from 24.4±2.7 kg/m2 to 25.6±5.2 (P=0.083). Subjects with progression in glycemic status had more severe COVID-19 illness than non-progressors (P=0.030). Reassessment was not performed in the control group.

Conclusion: Subjects who had dysglycemia in acute COVID-19 were characterized by insulin resistance. Over 1 year, a quarter had progression in glycemic status, especially those with more severe COVID-19. Importantly, there was no significant deterioration in insulin secretory capacity.

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来源期刊
Diabetes & Metabolism Journal
Diabetes & Metabolism Journal Medicine-Endocrinology, Diabetes and Metabolism
CiteScore
10.40
自引率
6.80%
发文量
92
审稿时长
52 weeks
期刊介绍: The aims of the Diabetes & Metabolism Journal are to contribute to the cure of and education about diabetes mellitus, and the advancement of diabetology through the sharing of scientific information on the latest developments in diabetology among members of the Korean Diabetes Association and other international societies. The Journal publishes articles on basic and clinical studies, focusing on areas such as metabolism, epidemiology, pathogenesis, complications, and treatments relevant to diabetes mellitus. It also publishes articles covering obesity and cardiovascular disease. Articles on translational research and timely issues including ubiquitous care or new technology in the management of diabetes and metabolic disorders are welcome. In addition, genome research, meta-analysis, and randomized controlled studies are welcome for publication. The editorial board invites articles from international research or clinical study groups. Publication is determined by the editors and peer reviewers, who are experts in their specific fields of diabetology.
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