title: Detecting diabetic risk using the oral glucose tolerance test in Chinese patients with hypertension: a cross-sectional study.
abstract: To analyze the clinical significance of the oral glucose tolerance test (OGTT) in the assessment of abnormal glucose metabolism in Chinese patients with hypertension. In this cross-sectional study of 10,173 hypertensive adult patients from eight sites in China, data on patient, clinical and disease characteristics were collected, and fasting plasma glucose (FPG) levels were measured. A subset of 5322 patients also underwent an OGTT. Abnormal glucose metabolism (impaired glucose regulation (IGR) or diabetes mellitus (DM)) was detected in 31.1% of the 10,173 patients by FPG testing and in 67% of the 5322 patients by OGTT. OGTT increased the detection rate by 35.8%. Patients with FPG levels ≥5.6 and ≥6.1 mmol l(-1) had the mean OGTT 2-h plasma glucose levels of 8.79 and 9.68 mmol l(-1), respectively. Compared with normoglycemic patients, those with IGR or DM had higher rates of total proteinuria (normoglycemic 15.8% vs. IGR 22.1% vs. DM 33.7%, P<0.001), a lower absolute estimated glomerular filtration rate (eGFR; in ml min(-1) per 1.73 m(2)) (82.9 vs. 80.77 vs. 79.74, P=0.06) and a higher prevalence of cardiovascular disease (normoglycemic 17.6% vs. IGR/DM 13.8%, P<0.001). Abnormal abdominal circumference, eGFR ≤60 ml min(-1) per 1.73 m(2), and proteinuria were independently associated with abnormal glucose metabolism (IGR or DM). Hypertensive patients who are diabetic or at risk of diabetes are at greater risk of renal damage and cardiovascular disease than those who are normoglycemic. It is insufficient to assess the glucose metabolism status of Chinese hypertensive patients using only FPG testing; the use of OGTT can increase the detection rate by 35.8%. Patients whose FPG levels were <5.6 mmol l(-1) may be found to have abnormal glucose metabolism after an OGTT.
authors.affiliation: Heart Center, Peking University People's Hospital, Beijing, China.
authors.forename: Ningling
authors.initials: N
authors.lastname: Sun
authors.affiliation: Heart Center, Peking University People's Hospital, Beijing, China.
authors.forename: Hongyi
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, China.
authors.forename: Yuemin
authors.initials: Y
authors.lastname: Sun
authors.affiliation: Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China.
authors.forename: Xiaoping
authors.initials: X
authors.lastname: Chen
authors.affiliation: Department of Hypertension, Henan Provincial People's Hospital, Zhengzhou, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Cardiology, Tangdu Hospital of The Fourth Military Medical University, Chongqing, China.
authors.forename: Lianyou
authors.initials: L
authors.lastname: Zhao
authors.affiliation: Department of Cardiology, Daqing Oilfield General Hospital of Heilongjiang Province, Daqing, China.
authors.forename: Jinping
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Hypertension and endocrinology, Daping Hospital of Chongqing, Chongqing, China.
authors.forename: Zhiming
authors.initials: Z
authors.lastname: Zhu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D044466:Asian People; D001786:Blood Glucose / Q000032:analysis / Q000378:metabolism; D001794:Blood Pressure / Q000502:physiology; D002318:Cardiovascular Diseases / Q000150:complications / Q000175:diagnosis; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D005919:Glomerular Filtration Rate; D005947:Glucose / Q000378:metabolism; D005951:Glucose Tolerance Test / Q000379:methods*; D006801:Humans; D006973:Hypertension / Q000150:complications*; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D011507:Proteinuria / Q000175:diagnosis; D015203:Reproducibility of Results; D018570:Risk Assessment; D055105:Waist Circumference; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D005947:Glucose