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Fasting plasma glucose and 2-h postprandial plasma glucose characteristics in a large multi-ethnic Chinese population

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International Journal of Diabetes in Developing Countries Aims and scope Submit manuscript

Abstract

Objective

During an oral glucose tolerance test (OGTT), typically fasting plasma glucose is lower than 2-h postprandial plasma glucose. However, postprandial plasma glucose (PPG) levels lower than fasting plasma glucose (FPG) levels may also occur. This study aims to describe the prevalence, clinical characteristics and contributing risk factors for PPG ≤ FPG in a large diverse Chinese population.

Methods

We conducted a cross-sectional analysis of baseline data from a nationwide cohort study conducted in China. In addition to sociodemographic and anthropometric data collection, individuals had OGTT and blood chemistry tests. We determined the prevalence of PPG ≤ FPG (‘Low Post Load’ group) and PPG > FPG (‘High Post Load’ group) and used logistic regression to evaluate the association of risk factors with the occurrence of Low Post Load.

Results

The prevalence of Low Post Load was 26.04% (n = 3773) and High Post Load was 73.96% (n = 10,714). Low Post Load was found to be related to younger age, male, lower BMI, lower blood pressure, higher HDL cholesterol levels and lower triglycerides levels. Compared with participants in the High Post Load group, participants in Low Post Load group had lower PPG (4.59 ± 0.83 mmol/L vs 7.15 ± 1.41 mmol/L) and HbA1c (5.30 ± 0.43% vs 5.39 ± 0.45%). People in Low Post Load group were more likely to have hypoglycaemic episodes (2.12% vs 0.01%) and impaired fasting glucose (12.30% vs 4.81%) compared with people with High Post Load, all p < 0.001.

Conclusions

We found a high prevalence of people with Low Post Load glucose (26.04%) in a Chinese population cohort. The relationship between Low Post Load and the progression to or protection from diabetes and related complications and future incidence of cardiovascular disease needs further exploration in longitudinal analyses.

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Data availability

The data that support the findings of this study are not openly available due to reasons of sensitivity, but are available from the corresponding author upon reasonable request.

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Acknowledgment

The authors wish to thank all the participants in this study, as well as the assistance provided by the medical staff from Zhongda Hospital, Southeast University.

Funding

This research was funded by the Key Research and Development Program in Jiangsu Province (grant number BE2022828) and the National Key R&D Program of China (grant number 2016YFC1305700). X. XU. is supported by China Scholarship Council (CSC).

Author information

Authors and Affiliations

  1. Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK

    Xiaohan Xu, Duolao Wang & Anupam Garrib

  2. Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing, China

    Xiaohan Xu, Shanhu Qiu, Bo Xie & Zilin Sun

  3. Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK

    Shabbar Jaffar

  4. Department of Cardiovascular & Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK

    Uazman Alam

  5. Diabetes & Neuropathy Research, Department of Medicine, 3rd Floor Clinical Sciences Centre, Liverpoool University NHS Hospital Foundation Trust, Longmoor Lane, Liverpool, UK

    Uazman Alam

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  1. Xiaohan Xu
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Corresponding authors

Correspondence to Zilin Sun or Anupam Garrib.

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Ethics approval

The study was conducted in accordance with the Declaration of Helsinki, and this study protocol was reviewed and approved by the Human Research Ethics Committee of Zhongda Hospital, Southeast University, approval number: 2016ZDSYLL092-P01. The names of the other institutions indicated in the Ethical approval were listed in the supplement.

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Highlights

• A quarter (26.04%) of participants in a Chinese population had plasma glucose levels following a 75 g glucose load that were equal to or less than their fasting plasma glucose value.

• Low Post Load was associated with a beneficial cardiometabolic profile with a lower BMI, lower blood pressure and favourable lipid profile.

• IFG occurred more frequently in participants without hypoglycaemia (12.54% vs 1.25%, p = 0.004).

• The relationship between this phenomenon and High Post Load glucose and the progression to prediabetes, diabetes and ‘hard’ cardiovascular outcomes in a Chinese population requires further longitudinal investigation.

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Xu, X., Wang, D., Jaffar, S. et al. Fasting plasma glucose and 2-h postprandial plasma glucose characteristics in a large multi-ethnic Chinese population. Int J Diabetes Dev Ctries (2023). https://doi.org/10.1007/s13410-023-01289-y

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