Objective To investigate the impact of OGTT 1-hour PG and 25-(OH) D3 on 3-year natural outcome in obese children with normal glucose tolerance.Methods From June 2012 to December 2013,a total of 297 children undergoing OGTT were selected in the Children's Hospital of Baoding,the Children's Hospital of Guiyang,the Affiliated Hospital of Jining Medical University and Hebei Provincial Children's Hospital,there into 238 cases' glucose tolerance were normal;according to the OGTTT 1-hour PG,the 238 children with normal glucose tolerance were divided into control group (with OGTT 1-hour PG equal or less than 8.6 mmol/L) and observation group (with OGTT over 8.6 mmol/L);according to the 3-year follow-up results,the 155 children with normal glucose tolerance were divided into A group (with normal glucose tolerance,n =123),B group (with abnormal glucose tolerance,n =25) and C group (with T2DM,n =7).Baseline laboratory examination results and 3-year natural outcome were compared between control group and observation group,baseline laboratory examination results and 25-(OH) D3 at the end of follow-up were compared among A group,B group and C group;Pearson correlation was used to analyze the correlation between 25-(OH) D3 and OGTT 1-hour PG in obese children with normal glucose tolerance.Results The rate of lost to follow-up was 34.9％ (83/238) durinng the 3-year follow-up;84cases of control group and 71 cases of observation group completed the follow-up eventually.No statistically significant differences of baseline 0-hour insulin,2-hour insulin,TG,TC,HDL-C or LDL-C was found between cotrrol group and observation group (P ＞0.05);baseline OGTT 0-hour PG,OG'TT 1-hour PG and OGTT 2-hour PG of observation group were statistically significantly higher than those of control group,while baseline 25-(OH) D3 of observation group was statistically significantly lower than that of control group (P ＜ 0.05).Natural outcome of observation group was statistically significantly worse than that of control group (P ＜ 0.05).No statistically significant differences of baseline 0-hour insulin,2-hour insulin,OGTT 0-hour PG,OGTT 2-hour PG,TG,TC,HDL-C or LDL-C was found among the A group,B group and C group (P ＞ 0.05);baseline OGTT 1-hour PG of B group and C group was statistically significantly higher than that of A group,respectively,while baseline 25-(OH) D3 of B group and C group was statistically significantly lower than that of A group,respectively (P ＜ 0.05);baseline OGTT 1-hour PG of C group was statistically significantly higher than that of B group,while baseline 25-(OH) D3 of C group was statistically significantly lower than that of B group (P ＜ 0.05).At the end of follow-up,25-(OH) D3 of B group and C group was statistically significantly lower than that of A group,respectively,meanwhile 25-(OH) D3 of C group was statistically significantly lower than that of B group (P ＜ 0.05).Pearson correlation analysis results showed that,25-(OH) D3 was negatively correlated with OGTT 1-hour PG in obese children with normal glucose tolerance (r =-0.20,P ＜ 0.05).Conclusion Both OGTT 1-hour PG and 25-(OH) D3 may affect the 3-year natural outcome in obese children with normal glucose tolerance,and OGTT 1-hour PG is negatively correlated with 25-(OH) D3.%目的 探讨口服葡萄糖耐量试验(OGTT)1 h血糖和25-羟维生素D3[25-(OH)D3]水平对糖耐量正常肥胖儿童3年自然转归的影响.方法 选取2012年6月-2013年12月在保定市儿童医院、贵阳市儿童医院、济宁医学院附属医院及河北省儿童医院行0GTT的肥胖儿童297例,其中糖耐量正常者238例;根据OGTT 1 h血糖将糖耐量正常儿童分为对照组(0GTT 1 h血糖≤8.6 mmol/L,n=142)和观察组(OGTT 1 h血糖＞8.6 mmol/L,n=96);两组儿童均随访3年,根据随访结果分为A组(糖耐量正常,n=123)、B组(糖耐量异常,n=25)及C组[2型糖尿病(T2DM),n=7].比较对照组与观察组儿童基线实验室检查指标及随访3年自然转归,比较A组、B组和C组儿童基线实验室检查指标及随访结束时25-(OH)D3水平;25-(OH) D3水平与糖耐量正常肥胖儿童OGTT 1 h血糖的相关性分析采用Pearson相关性分析.结果 随访3年,失访83例,失访率为34.9％;最终对照组共84例儿童完成随访,观察组共71例儿童完成随访.对照组与观察组儿童基线0h胰岛素、2h胰岛素及三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)水平比较,差异无统计学意义(P＞0.05);观察组儿童基线OGTT0h血糖、1h血糖、2h血糖高于对照组,基线25-(OH) D3水平低于对照组(P＜0.05).随访3年,观察组儿童自然转归劣于对照组(P＜0.05).A组、B组及C组儿童基线0h胰岛素、2h胰岛素、OGTT 0 h血糖、OGTT2 h血糖及TG、TC、HDL-C、LDL-C水平比较,差异无统计学意义(P＞0.05);B组和C组儿童基线OGTT1h血糖高于A组,基线25-(OH) D3水平低于A组(P＜0.05);C组儿童基线OGTT 1 h血糖高于B组,基线25-(OH) D3水平低于B组(P＜0.05).B组C组儿童随访方结束时25-(OH) D3水平低于A组,C组儿童随访结束时25-(OH)D3水平低于B组(P＜0.05).Pearson相关性分析结果显示,25-(OH)D3水平与糖耐量正常肥胖儿童OGTT 1 h血糖呈负相关(r=-0.20,P＜0.05).结论 OGTT 1 h血糖和25-(OH) D3水平均可影响糖耐量正常肥胖儿童3年自然转归,且OGTT 1 h血糖与25-(OH) D3水平呈负相关.
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