Oral Glucose Tolerance Test in Pregnancy and Subsequent Maternal Hypertension

2021 ◽  
Author(s):  
Maged M. Costantine ◽  
Madeline Murguia Rice ◽  
Mark B. Landon ◽  
Michael W. Varner ◽  
Brian M. Casey ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Primary Outcome ◽  
Glucose Tolerance Test ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Oral Glucose Tolerance ◽  
Index Pregnancy ◽  
Unit Increase ◽  
Stage 1

Objective The aim of the study is to evaluate whether values and the shape of the glucose curve during the oral glucose tolerance test (OGTT) in pregnancy identify women at risk of developing hypertension (HTN) later in life. Methods This category includes the secondary analysis of a follow-up from a mild gestational diabetes mellitus (GDM) study that included a treatment trial for mild GDM (n = 458) and an observational cohort of participants with abnormal 1-hour glucose loading test only (normal OGTT, n = 430). Participants were assessed at a median of 7 (IQR 6–8) years after their index pregnancy, and trained staff measured their blood pressure (systolic blood pressure [SBP]; diastolic blood pressure [DBP]). The association between values and the shape of the glucose curve during OGTT in the index pregnancy and the primary outcome defined as elevated BP (SBP ≥120, DBP ≥80 mm Hg, or receiving anti-HTN medications), and secondary outcome defined as stage 1 or higher (SBP ≥130, DBP ≥80 mm Hg, or receiving anti-HTN medications) at follow-up were evaluated using multivariable regression, adjusting for maternal age, body mass index, and pregnancy-associated hypertension during the index pregnancy. Results There was no association between fasting, 1-hour OGTT, and the outcomes. However, the 2-hour OGTT value was positively associated (adjusted odds ratio [aRR] per 10-unit increase 1.04, 95% CI 1.01–1.08), and the 3-hour was inversely associated (aRR per 10-unit increase 0.96, 95% CI 0.93–0.99) with the primary outcome. When the shape of the OGTT curve was evaluated, a monophasic OGTT response (peak at 1 hour followed by a decline in glucose) was associated with increased risk of elevated BP (41.3vs. 23.5%, aRR 1.66, 95% CI 1.17–2.35) and stage 1 HTN or higher (28.5 vs. 14.7%, aRR 1.83, 95% CI 1.15–2.92), compared with a biphasic OGTT response. Conclusion Among persons with mild GDM or lesser degrees of glucose intolerance, the shape of the OGTT curve during pregnancy may help identify women who are at risk of HTN later in life, with biphasic shape to be associated with lower risk. Key Points

scholarly journals Oral Glucose Tolerance Test Predicts Episodic Memory Decline: A 10-Year Population-Based Follow-up Study

2021 ◽  
Author(s):  
Sini Toppala ◽  
Laura L. Ekblad ◽  
Matti Viitanen ◽  
Juha O. Rinne ◽  
Antti Jula
Keyword(s):  
Glucose Tolerance ◽  
Oral Glucose Tolerance Test ◽  
Glucose Tolerance Test ◽  
Word List ◽  
Tolerance Test ◽  
Population Based ◽  
Oral Glucose ◽  
Oral Glucose Tolerance ◽  
Delayed Recall

<i>Objective</i>: To examine if the 2-hour value of an oral glucose tolerance test (OGTT) can predict cognitive decline. <p><i>Research design and methods</i>: This study is based on a subpopulation of the Finnish population-based Health 2000 Survey, and its follow-up, the Health 2011 study. Altogether 961 individuals aged 45–74 (mean 55.6 years, 55.8% women) underwent OGTT in 2001–2002. Categorical verbal fluency, word-list learning, and word-list delayed recall were tested at baseline and at follow-up in 2011. Statistical analyses were performed with multivariable linear models adjusted for previously reported risk factors for cognitive decline.</p> <p><i>Results</i>: A higher 2-hour glucose value in the OGTT at baseline predicted worse performance (slope: -0.08, p=0.01) and greater decline (slope: -0.07, p=0.007) in the word-list delayed recall test after 10 years. </p> <p><i>Conclusions</i>: Our results indicate that higher 2-hour glucose values in the OGTT predict a decline in episodic memory after 10 years. </p>

Oral glucose tolerance test reduces arterial baroreflex sensitivity in older adults

2008 ◽  
Vol 86 (3) ◽  
pp. 71-77 ◽  
Author(s):  
Kenneth M. Madden ◽  
Gale Tedder ◽  
Chris Lockhart ◽  
Graydon S. Meneilly
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
Glucose Tolerance ◽  
Oral Glucose Tolerance Test ◽  
Glucose Tolerance Test ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Arterial Baroreflex ◽  
Oral Glucose Tolerance ◽  
Healthy Older Adults

Although postprandial decreases in blood pressure are a common cause of syncope in the older adult population, the postprandial effects of the oral glucose tolerance test on blood pressure and the arterial baroreflex remain poorly characterized in older adults. Therefore, arterial blood pressure and the arterial baroreflex were studied in 19 healthy older adults (mean age 71.7 ± 1.1 years) who were given a standardized oral glucose load (75 g) or an isovolumetric sham drink during 2 separate sessions. All measures were taken for 120 min after treatment. Baroreflex function was assessed by using the spontaneous baroreflex method (baroreflex sensitivity, BRS). Subjects demonstrated a decrease in BRS after oral glucose that was not seen in the placebo session (two-way analysis of variance, p = 0.04). There was no significant change in systolic, mean, or diastolic blood pressure; together with a drop in BRS, this resulted in a significant tachycardia post glucose (two-way analysis of variance, p < 0.001). We conclude that healthy older adults can successfully maintain blood pressure during an oral glucose tolerance test despite a decrease in arterial BRS. Decreased BRS resulted in a tachycardic response to glucose.

Reliability of the oral glucose tolerance test in the early postoperative assessment of acromegaly remission

2002 ◽  
Vol 97 (6) ◽  
pp. 1282-1286 ◽  
Author(s):  
Rudolf A. Kristof ◽  
Georg Neuloh ◽  
Lioba Redel ◽  
Dietrich Klingmüller ◽  
Johannes Schramm
Keyword(s):  
Pituitary Adenomas ◽  
Glucose Tolerance Test ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Oral Glucose Tolerance ◽  
Content Type ◽  
Highly Sensitive ◽  
Igf I ◽  
Fine Print

Object. The suppression of growth hormone (GH) to less than 1 µg/L during the oral glucose tolerance test (OGTT) is generally considered to be the standard for the assessment of biochemical remission of GH excess following surgery for GH-secreting pituitary adenomas. In this study the authors examine the reliability of the results of the early postoperative OGTT (epOGTT) in indicating remission or persistence of active acromegaly. Methods. Data from the case files of 67 consecutive patients who underwent surgery for the first time for GH-secreting pituitary adenomas were reviewed retrospectively. Definitive remission of acromegaly was considered to be present if, without adjuvant therapy and at the most recent follow-up examination, GH was suppressed to less than 1 µg/L during the OGTT, the level of insulin-like growth factor—I (IGF-I) was within normal limits, and there was no clinical or magnetic resonance imaging evidence of persisting disease. The results of the epOGTT (obtained during the 2nd postoperative week) and the 3-month-postoperative OGTT (3mpOGTT) were compared with the patient's outcome at the most recent follow-up examination. A highly sensitive (≤ 0.3 µg/L) immunoradiometric assay for GH and a highly sensitive (≤ 32 µg/L) radioimmunoassay for IGF-I were used. Correct epOGTT findings were noted in 83.6% of the patients: correct normal results (definitive remission of acromegaly) in 55.2% and correct pathological results (persisting acromegaly) in 28.3% of the patients. The rate of false findings was 16.4%: false normal results in 1.5% and false pathological results in 14.9% of the patients. The rate of correct 3mpOGTT findings increased to 98.5%: correct normal results in 68.6% and correct pathological ones in 29.8% of the patients. A false (false pathological) 3pmOGTT result occurred in only one patient (1.5%). At the most recent follow-up examinations (median 3.6 years) all OGTT findings were correct: correct normal results in 70.1% and correct pathological results in 29.9% of the patients. An intact adenopituitary function was associated (p = 0.04) with the occurrence of false epOGTT findings. Conclusions. The high rate of false results, 16.4% for the epOGTT, declined significantly to 1.5% 3 months postoperatively and to 0% at the most recent follow-up examination. The OGTT appears to be more reliable at 3 months postoperatively. Unless there is obvious evidence of persisting disease following surgery for GH-secreting pituitary adenomas, adjuvant therapy should be delayed for 3 months postoperatively to avoid subjecting the patient to superfluous treatment.

scholarly journals Oral Glucose Tolerance Test Predicts Episodic Memory Decline: A 10-Year Population-Based Follow-up Study

2021 ◽  
Author(s):  
Sini Toppala ◽  
Laura L. Ekblad ◽  
Matti Viitanen ◽  
Juha O. Rinne ◽  
Antti Jula
Keyword(s):  
Glucose Tolerance ◽  
Oral Glucose Tolerance Test ◽  
Glucose Tolerance Test ◽  
Word List ◽  
Tolerance Test ◽  
Population Based ◽  
Oral Glucose ◽  
Oral Glucose Tolerance ◽  
Delayed Recall

<i>Objective</i>: To examine if the 2-hour value of an oral glucose tolerance test (OGTT) can predict cognitive decline. <p><i>Research design and methods</i>: This study is based on a subpopulation of the Finnish population-based Health 2000 Survey, and its follow-up, the Health 2011 study. Altogether 961 individuals aged 45–74 (mean 55.6 years, 55.8% women) underwent OGTT in 2001–2002. Categorical verbal fluency, word-list learning, and word-list delayed recall were tested at baseline and at follow-up in 2011. Statistical analyses were performed with multivariable linear models adjusted for previously reported risk factors for cognitive decline.</p> <p><i>Results</i>: A higher 2-hour glucose value in the OGTT at baseline predicted worse performance (slope: -0.08, p=0.01) and greater decline (slope: -0.07, p=0.007) in the word-list delayed recall test after 10 years. </p> <p><i>Conclusions</i>: Our results indicate that higher 2-hour glucose values in the OGTT predict a decline in episodic memory after 10 years. </p>

scholarly journals Brain-Derived Neurotrophic Factor during Oral Glucose Tolerance Test Predicts Cardiovascular Outcomes

2020 ◽  
Vol 21 (14) ◽  
pp. 5008
Author(s):  
I-Te Lee ◽  
Yu-Hsuan Li ◽  
Wayne Huey-Herng Sheu
Keyword(s):  
Glucose Tolerance ◽  
Oral Glucose Tolerance Test ◽  
Primary Endpoint ◽  
Neurotrophic Factor ◽  
Glucose Tolerance Test ◽  
Brain Derived Neurotrophic Factor ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Oral Glucose Tolerance

We investigated if brain-derived neurotrophic factor (BDNF) accumulation after glucose intake could predict cardiovascular outcomes. We enrolled patients admitted for angiography due to angina. After their conditions stabilized, serum BDNF levels were detected at 0, 30, and 120 min during oral glucose tolerance test (OGTT). Area under the curve (AUC) of BDNF was calculated. The first occurrence of nonfatal myocardial infarction, nonfatal stroke, and all-cause mortality served as the primary composite endpoint. Of 480 enrolled patients, 428 completed the follow-up, and 36 primary endpoint events occurred during a median follow-up of 4.4 years. The area under the receiver operating characteristic curve significantly increased from 0.61 (95% confidence interval (CI): 0.52–0.73) for the Framingham risk score (FRS) alone model to 0.72 (95%CI: 0.63–0.81) for the AUC of BDNF plus FRS model (p = 0.016) for predicting the primary endpoint, but not to 0.65 (95%CI: 0.55–0.75) for the fasting BDNF plus FRS model (p = 0.160). Grouped by median AUC of BDNF of 38.0 (ng/mL) × h, the low BDNF group had a significantly higher risk of the endpoint than the high BDNF group (hazard ratio = 3.410, 95%CI: 1.520–7.653, p = 0.003). In conclusion, AUC of BDNF during OGTT could be superior to fasting BDNF for predicting a low cardiovascular risk.

scholarly journals A 10 year follow-up of diabetes in a rural area of Japan using the 50g oral glucose tolerance test.

1983 ◽  
Vol 141 (Suppl) ◽  
pp. 111-114
Author(s):  
KANJI KOMATSU ◽  
NORIHIKO MORIAI ◽  
CHIYUKI NAKANOME ◽  
WAICHI SATOH ◽  
SHIOKO SASAKI ◽  
...  
Keyword(s):  
Glucose Tolerance ◽  
Oral Glucose Tolerance Test ◽  
Rural Area ◽  
Glucose Tolerance Test ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Oral Glucose Tolerance

Oral glucose tolerance test within the scope of prenatal care: Evaluation 2010–2012

2015 ◽  
Vol 38 (2) ◽  
Author(s):  
Erich Krendl ◽  
Maria Elisabeth Mustafa
Keyword(s):  
Glucose Tolerance ◽  
Oral Glucose Tolerance Test ◽  
Pregnant Women ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Glucose Tolerance Test ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Oral Glucose Tolerance

AbstractGeneral screening for gestational diabetes mellitus (GDM) is recommended in Austria since 2010. As a result of the guidelines, pregnant women are tested between 24 and 28 weeks of gestation with the 75 g/2 h-oral glucose tolerance test (75 g/2 h-OGTT). The aim of this study was to evaluate the prevalence of GDM in our laboratory retrospectively. Furthermore, we wanted to study the pattern of abnormal 1 h- and 2 h-glucose values from 75 g/2 h-OGTTs compared with fasting plasma glucose values. Further testing of GDM patients after delivery is recommended. As a result of this issue we analyzed all follow-up screening.Standardized 75 g/2 h-OGTTs were assessed in 3963 pregnant women. The cut-off value for fasting plasma glucose (FPG) is ε 5.1 mmol/L, for 1 h value ε 10.0 mmol/L, and for 2 h value ε 8.5 mmol/L. One or more abnormal values were considered as GDM, respectively.GDM was detected in 8.5% (n=335) of the tested pregnant women. Elevated FPG values were measured in 5.1% (n=201). These are 60% of all GDM patients. After delivery we analyzed 14 out of 335 GDM patients (4.2%) to reevaluate postpartum glucose tolerance with the standard OGTT (World Health Organization criteria).GDM is a common disease, and in our study 8.5% of pregnancies were affected. When and how to screen is still a matter of discussion. One strategy to become more cost-effective is to use a two-step screening algorithm including FPG measurement and a risk estimation model. In postpartum follow-up, there is still considerable potential to reduce diabetes-associated illness and costs.

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