Seventy-five gram glucose tolerance test to assess carbohydrate malabsorption and small bowel bacterial overgrowth  

作　　者：Yoshihisa Urita Susumu Ishihara Tatsuo Akimoto Hiroto Kato Noriko Hara Yoshiko Honda Yoko Nagai Kazushige Nakanishi Nagato Shimada Motonobu Sugimoto Kazumasa Miki 

机构地区：[1]Department of General Medicine and Emergency Care Toho University School of Medicine,Omori Hospital,Tokyo,Japan [2]Division of Gastroenterology and Hepatology Department of Internal Medicine,Toho University School of Medicine,Omori Hospital,Tokyo,Japan

出　　处：《World Journal of Gastroenterology》2006年第19期3092-3095,共4页世界胃肠病学杂志（英文版）

摘　　要：AIM： To investigate non-invasively the incidence of absorption of carbohydrates in diabetic patients during an oral glucose tolerance test （OGTT） and to determine whether malabsorption may be associated with insulin secretion and insulin resistance. METHODS： A standard 75-g OGTT was performed in 82 diabetic patients. The patients received 75 g of anhydrous glucose in 225 mL of water after an overnight fasting and breath samples were collected at baseline and up to 120 rain after ingestion. Breath hydrogen and methane concentrations were measured. Blood glucose and serum insulin concentrations were measured before ingestion and at 30, 60, 90, 120 rain post-ingestion. RESULTS： When carbohydrate malabsorption was defined as subjects with an increase of at least 10 ppm （parts per million） in hydrogen or methane excretion within a 2-h period, 28 （34%） had carbohydrate malabsorption. According to the result of increased breath test, 21 （75%） patients were classified as small bowel bacterial overgrowth and 7 （25%） as glucose malabsorption. Patients with carbohydrate malabsorption were older and had poor glycemic control as compared with those without carbohydrate malabsorption. The HOMA value, the sum of serum insulin during the test and the AinsulinlAglucose ratio were greater in patients with carbohydrate malabsorption. CONCLUSION： Insulin resistance may be overestimated by using these markers if the patient has carbohydrate malabsorption, or that carbohydrate malabsorption may be present prior to the development of insulin resistance. Hence carbohydrate malabsorption should be taken into account for estimating insulin resistance and β-cell function.瞄准：non-invasively 在口头的葡萄糖耐量测试(OGTT ) 期间在糖尿病的病人调查糖类的吸收的发生并且决定吸收不良是否可以与胰岛素分泌物和抗胰岛素性被联系。方法：标准 75-g OGTT 在 82 个糖尿病的病人被执行。病人在一夜的禁食以后在水的 225 mL 收到了无水的葡萄糖的 75 g，呼吸样品在摄取以后在基线和多达 120 min 是镇定的。呼吸氢和甲烷集中被测量。血葡萄糖和浆液胰岛素集中在摄取前并且在 30 点被测量， 60， 90， 120 min 摄取以后。结果：当糖类吸收不良在一个 2-h 时期以内随氢或甲烷排泄的至少 10 ppm (兆比率) 的增加被定义为题目时，(34%) 28 有糖类吸收不良。根据增加的呼吸测试的结果， 21 (75%) 病人们作为小肠被分类细菌的增生并且 7 (25%) 是葡萄糖吸收不良。没有糖类吸收不良，有糖类吸收不良的病人作为与那些相比是更旧、有的差的 glycemic 控制。HOMA 价值，浆液胰岛素的和在有糖类吸收不良的病人在测试和三角洲胰岛素 / 三角洲葡萄糖比率期间是更大的。结论：如果病人有糖类吸收不良，抗胰岛素性可以被使用这些标记过高估计，否则那糖类吸收不良可能在抗胰岛素性的发展以前是在场的。因此糖类吸收不良应该为估计抗胰岛素性和贝它房间功能被考虑。

关 键 词：75-g OGTT Carbohydrate malabsorption Bacterial overgrowth Breath test Insulin resistance 

分 类 号：R574[医药卫生—消化系统]