Glucose metabolism profile recorded by flash glucose monitoring system in patients with hypopituitarism during prednisone replacement  

作　　者：Min-Min Han Jia-Xin Zhang Zi-Ang Liu Lin-Xin Xu Tao Bai Chen-Yu Xiang Jin Zhang Dong-Qing Lv Yan-Fang Liu Yan-Hong Wei Bao-Feng Wu Yi Zhang Yun-Feng Liu 

机构地区：[1]Department of Endocrinology,First Hospital of Shanxi Medical University,Taiyuan 030000,Shanxi Province,China [2]The First Clinical Medical College of Shanxi Medical University,Taiyuan 030000,Shanxi Province,China [3]Department of General Medicine,The Third Hospital of Shanxi Medical University,Shanxi Bethune Hospital,Shanxi Academy of Medical Sciences,Tongji Shanxi Hospital,Taiyuan 030000,Shanxi Province,China [4]Department of Pharmacology,Shanxi Medical University,Taiyuan 030000,Shanxi Province,China

出　　处：《World Journal of Diabetes》2023年第7期1112-1125,共14页世界糖尿病杂志（英文版）（电子版）

基　　金：Supported by National Natural Science Foundation of China,No.81770776,No.81973378,and No.82073909;The Shanxi Provincial Central Leading Local Science and Technology Development Fund Project,No.YDZJSX2022A059;Postgraduate Education Innovation Project of Shanxi Province,No.2022Y354.

摘　　要：BACKGROUND Commonly used glucocorticoids replacement regimens in patients with hypopituitarism have difficulty mimicking physiological cortisol rhythms and are usually accompanied by risks of over-treatment,with adverse effects on glucose metabolism.Disorders associated with glucose metabolism are established risk factors of cardiovascular events,one of the life-threatening ramifications.AIM To investigate the glycometabolism profile in patients with hypopituitarism receiving prednisone(Pred)replacement,and to clarify the impacts of different Pred doses on glycometabolism and consequent adverse cardiovascular outcomes.METHODS Twenty patients with hypopituitarism receiving Pred replacement[patient group(PG)]and 20 normal controls(NCs)were recruited.A flash glucose monitoring system was used to record continuous glucose levels during the day,which provided information on glucose-target-rate,glucose variability(GV),period glucose level,and hypoglycemia occurrence at certain periods.Islet β-cell function was also assessed.Based on the administered Pred dose per day,the PG was then regrouped into Pred>5 mg/d and Pred≤5 mg/d subgroups.Comparative analysis was carried out between the PG and NCs.RESULTS Significantly altered glucose metabolism profiles were identified in the PG.This includes significant reductions in glucose-target-rate and nocturnal glucose level,along with elevations in GV,hypoglycemia occurrence and postprandial glucose level,when compared with those in NCs.Subgroup analysis indicated more significant glucose metabolism impairment in the Pred>5 mg/d group,including significantly decreased glucose-target-rate and nocturnal glucose level,along with increased GV,hypoglycemia occurrence,and postprandial glucose level.With regard to islet β-cell function,PG showed significant difference in homeostasis model assessment(HOMA)-β compared with that of NCs;a notable difference in HOMA-βwas identified in Pred>5 mg/d group when compared with those of NCs;as for Pred≤5 mg/d group,significant differences we

关 键 词：HYPOPITUITARISM PREDNISONE Flash glucose monitoring system Glucose-target-rate Glucose variability Period glucose level 

分 类 号：R584[医药卫生—内分泌]