Oral Gucose Tolerance Test in Metabolic Syndrome Patients

Author: P. Angelova-Gateva, S. Zaharieva, A. Tomova, N. Ovcharova, N. U. Lozanov, A. Elenkova, Clinical Center of Endocrinology and Gerontology Medical University – Sofia

The metabolic syndrome (MS) is determined as a world epidemic in the beginning of the 21 century. The main symptoms of the metabolic syndrome are the central obesity, hyperglycemia with impaired glucose tolerance, hyperinsulinaemia, dislipidemia and hypertension. The aim of the study was to investigate carbohydrate disturbances by OGTT in patients with metabolic syndrome and to study hyperglycemia, after loading with 75 g glucose per os. The oral glucose tolerance test (OGTT) was carried out in 400 hospitalized patients (103 males and 297 females), aged 21 to 76 years. The capillary blood samples for serum glucose were obtained at the 0 minute – fasting blood glucose (FBG) and after 75 g glucose per os loading at the 30, 60, 120 and 180 minute. The mean serum glucose values at the 0 min were 4,75 ± 2,14 mmol/l, at the 30 min – 7,98 ± 3,15 mmol/l, at the 60 min – 9,25 ± 4,34 mmol/l, at the 120 min – 6,50 ± 2,95 mmol/l and 4,63 ± 2,97 mmol/ I at the 180 min they were compared with the WHO criteria (9, 10, 11, 12). The difference between the mean values of the fasting blood glucose and at minute 60 was calculate, noted as increase (D1), as well the difference between the 60 and 120 minute values, named decrease (D2), so was the ratio D1/D2. The D1 was 3,4 mmol/l in the reference groupe, 4,8 mmol/l in the impaired glucose tolerance group, and 4,1 mmol/l in diabetic patients. In the group of the investigated 400 patients with metabolic syndrom D1 was 4,5 mmol/l, which characterize them as impaired glucose tolerance cases. The values of D2 were 2,73 in the investigated MS patients, and respectively 1,1, 1,4 and 0,0 in the reference groups. These value can be used in one shortened OGTT as valuable information. The ratio value D1/ D2 in the reference groups were respectively 3,0, 3,43 and 4,1 in diabetics. In our metabolic syndrom patients the value was 1,65. The data demonstrate that the OGTT, especially the values of the blood glucose increase D1 and D1/D2 are very important for the diagnosis of the metabolic syndrom. The conclusion is that the D1 and the ratio D1/D2 can be used in the begining of the diagnostic process of the metabolic syndrom, before insulin level investigation, which saves time and money.

 

Keywords: OGTT, glucose, metabolic syndrom.