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期刊来源：Nat Med

原文链接：https://doi.org/10.1038/s41591-024-02908-9

摘要内容如下：

在全世界范围内，空腹血糖（FG）水平在糖尿病前期和糖尿病的诊断中起着关键作用。在此，我们使用连续血糖监测（CGM）装置研究了40-70岁非糖尿病成年人的Fg值。在8，315名受试者的59，565个早晨窗口（每个参与者7.16±3.17天）中测量了FG。平均FG为96.2±12.87mgdL-1，随年龄增长每年增加0.234mgdL-1。个体内，以FG标准差表示的逐日变异为7.52±4.31mgdl-1。由于目前尚无基于CGM的糖尿病诊断标准，我们根据当前基于血浆FG的诊断指南，分析了这种变异性对血糖状态分类的潜在影响。在5328名根据第一次FG测量被认为具有正常FG的个体中，根据整个研究的连续测量，分别有40%和3%的个体被重新分类为具有糖尿病前期和糖尿病范围内的葡萄糖。最后，我们揭示了平均FG与各种临床指标之间的关系。我们的研究结果表明，在解释FG时有必要仔细考虑，因为存在大量的个体内变异性，并强调使用CGM数据来完善血糖状态评估的潜在影响。

英文原文如下：

Abstracts

Plasma fasting glucose (FG) levels play a pivotal role in the diagnosis of prediabetes and diabetes worldwide. Here we investigated FG values using continuous glucose monitoring (CGM) devices in nondiabetic adults aged 40-70 years. FG was measured during 59,565 morning windows of 8,315 individuals (7.16 ± 3.17 days per participant). Mean FG was 96.2 ± 12.87 mg dl-1, rising by 0.234 mg dl-1 per year with age. Intraperson, day-to-day variability expressed as FG standard deviation was 7.52 ± 4.31 mg dl-1. As there are currently no CGM-based criteria for diabetes diagnosis, we analyzed the potential implications of this variability on the classification of glycemic status based on current plasma FG-based diagnostic guidelines. Among 5,328 individuals who would have been considered to have normal FG based on the first FG measurement, 40% and 3% would have been reclassified as having glucose in the prediabetes and diabetes ranges, respectively, based on sequential measurements throughout the study. Finally, we revealed associations between mean FG and various clinical measures. Our findings suggest that careful consideration is necessary when interpreting FG as substantial intraperson variability exists and highlight the potential impact of using CGM data to refine glycemic status assessment.

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