摘要目的:比较口服葡萄糖耐量试验（OGTT）诊断的糖调节受损（IGR）和糖化血红蛋白（HbA 1c）定义的糖尿病前期（PreDM）人群的临床特征。 方法:本研究为横断面研究。2019年7至11月在北京市延庆区招募符合成人糖尿病高危人群定义且未接受过任何干预的受试者402例。分别用75 g OGTT和HbA 1c评估糖代谢状态，测量身高、体重、收缩压（SBP）、舒张压（DBP），检测空腹血糖（FPG）、负荷后2 h血糖（2 h PG）、空腹胰岛素（FINS）、负荷后2 h胰岛素（2 h INS）、甘油三酯（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）等。计算体质指数（BMI）、稳态模型评估β细胞功能指数（HOMA-β）、稳态模型评估胰岛素抵抗指数（HOMA-IR）、Matsuda指数等。根据2019年美国糖尿病学会标准分为IGR组和HbA 1c定义的PreDM组，比较两组间各临床指标的差异。两组间比较采用独立样本 t检验或Mann-Whitney U检验，多组间比较采用单因素方差分析或Kruskal-Wallis H检验。计数资料比较采用χ2检验。 结果:排除5例血红蛋白<110 g/L的受试者，共有397例受试者进行糖代谢状态评估。根据OGTT诊断IGR 161例（40.6%），根据HbA 1c诊断PreDM 188例（47.4%）。与IGR组相比，PreDM组BMI［（28.7±9.2）和（26.1±3.7）kg/m 2， t=-3.335， P<0.01］和Matsuda指数［4.64（3.21，6.89）和4.08（2.85，5.95）， Z=-2.443， P<0.05］更高，FPG［（5.7±0.5）和（5.9±0.6）mmol/L， t=3.611， P<0.01］、2 h PG［（7.4±1.9）和（8.7±1.6） mmol/L， t=6.757， P<0.01］及2 h INS［（56.8±45.7）和（69.3±50.5）mIU/L， t=2.418， P<0.05］更低，SBP、DBP、FINS、HbA 1c、TG、TC、LDL-C、HDL-C、HOMA-β及HOMA-IR差异无统计学意义（均 P>0.05）。进一步分析显示，与IGR但HbA 1c<5.7%亚组相比，单纯符合PreDM亚组中2 h PG和2 h INS更低、HbA 1c更高（均 P<0.05），BMI、SBP、DBP、FPG、FINS、TG、TC、LDL-C、HDL-C、HOMA-β、HOMA-IR及Matsuda指数差异无统计学意义（均 P>0.05）。 结论:IGR与HbA 1c定义的PreDM两组人群之间，不仅血糖变化谱有所不同，而且BMI、胰岛素敏感性、胰岛β细胞功能等指标也存在差异。

abstractsObjective:To compare clinical characteristics of impaired glucose regulation (IGR) diagnosed with oral glucose tolerance test (OGTT) and prediabetes (PreDM) with glycated hemoglobin A 1c (HbA 1c). Methods:This was a cross-sectional study. A total of 402 subjects who were high-risk for diabetes from Yanqing District in Beijing underwent a 75 g OGTT and an HbA 1c test during July 2019 to November 2019. The data of height, weight, systolic blood pressure (SBP), and diastolic blood pressure (DBP) were collected. Fasting plasma glucose (FPG), 2-hour postload blood glucose (2 h PG), fasting insulin (FINS), 2-hour postload insulin (2 h INS), triglyceride (TG), total cholesterol (TC), low-density lipoprotein-cholesterol (LDL-C), and high-density lipoprotein-cholesterol (HDL-C) were examined. The body mass index (BMI), homeostasis model assessment of β cell function (HOMA-β), homeostasis model assessment of insulin resistance (HOMA-IR) and Matsuda index were calculated. According to the 2019 American Diabetes Association criteria, the patients were divided into IGR group and PreDM group. All indicators between two groups were compared using independent samples t test or Mann-Whitney U test. One-way analysis of variance or Kruskal-Wallis H test were used for multiple comparisons. The enumeration data were compared using Chi-squared test. Results:A total of 397 subjects were included after excluding 5 subjects with hemoglobin<110 g/L. Of which, 161 (40.6%) were IGR and 188 (47.4%) were PreDM. The BMI [(28.7±9.2) vs (26.1±3.7) kg/m 2, t=-3.335, P<0.05] and Matsuda index [4.64 (3.21, 6.89) vs 4.08 (2.85, 5.95), Z=-2.443, P<0.05] in IGR group were lower than those in PreDM group, and the levels of FPG [(5.7±0.5) vs (5.9±0.6) mmol/L, t=3.611, P<0.01], 2 h PG [(7.4±1.9) vs (8.7±1.6) mmol/L, t=6.757, P<0.01] and 2 h INS [(56.8±45.7) vs (69.3±50.5) mU/L, t=2.418, P<0.05] were higher than those in PreDM group. There were no significant differences in the level of SBP, DBP, FINS, HbA 1c, TG, TC, LDL-C, HDL-C, HOMA-β and HOMA-IR between two groups (all P>0.05). Compared to IGR subgroup with HbA 1c<5.7%, 2 h PG and 2 h INS were lower while level of HbA 1c was higher in PreDM subgroup (all P<0.05). There were no significant differences in the level of BMI, SBP, DBP, FPG, FINS, TG, TC, LDL-C, HDL-C, HOMA-β, HOMA-IR and Matsuda index between two groups (all P>0.05). Conclusion:IGR and HbA 1c-defined PreDM not only have different hyperglycemic profiles, but also varies in BMI, insulin resistance and β cell function.