CAJ | 학술논문

目的：通过口服葡萄糖耐量试验（OGTT）了解无糖尿病病史的乳腺癌患者系统治疗后糖耐量异常状况。方法：对121例系统治疗（手术治疗和/或化疗）结束后3个月以上无糖尿病病史的乳腺癌患者行OGTT检测，检测空腹及OGTT餐后2 h血糖值以明确此类患者有无伴随糖耐量异常，同期6例有糖尿病病史的乳腺癌患者未行OGTT检测。结果：患者平均随访年龄为50.4岁，系统治疗后平均随访时间为19个月。在121例无糖尿病病史的乳腺癌患者中：糖尿病（即未知晓糖尿病）和糖尿病前期发生率分别为19.8%（24/121）和45.5%（55/121），糖耐量相对正常仅占34.7%（42/121）；在所有127例系统治疗后的乳腺癌患者中已知晓糖尿病、未知晓糖尿病及糖尿病前期发生率分别为4.72%（6/127）、18.9%（24/127）和43.3%（55/127），其中糖尿病的未知晓率高达80%。约80%的糖尿病及74.5%糖尿病前期的诊断需经OGTT餐后2 h血糖检测确诊而非空腹血糖检测。结论：系统治疗后的乳腺癌患者存在明显的糖代谢紊乱，伴有高比例的未知晓糖尿病和糖尿病前期，对此类患者建议行OGTT检测，以利于早期诊断和防治糖尿病的发生，改善预后。
목적：통과구복포도당내량시험（OGTT）료해무당뇨병병사적유선암환자계통치료후당내량이상상황。방법：대121례계통치료（수술치료화/혹화료）결속후3개월이상무당뇨병병사적유선암환자행OGTT검측，검측공복급OGTT찬후2 h혈당치이명학차류환자유무반수당내량이상，동기6례유당뇨병병사적유선암환자미행OGTT검측。결과：환자평균수방년령위50.4세，계통치료후평균수방시간위19개월。재121례무당뇨병병사적유선암환자중：당뇨병（즉미지효당뇨병）화당뇨병전기발생솔분별위19.8%（24/121）화45.5%（55/121），당내량상대정상부점34.7%（42/121）；재소유127례계통치료후적유선암환자중이지효당뇨병、미지효당뇨병급당뇨병전기발생솔분별위4.72%（6/127）、18.9%（24/127）화43.3%（55/127），기중당뇨병적미지효솔고체80%。약80%적당뇨병급74.5%당뇨병전기적진단수경OGTT찬후2 h혈당검측학진이비공복혈당검측。결론：계통치료후적유선암환자존재명현적당대사문란，반유고비례적미지효당뇨병화당뇨병전기，대차류환자건의행OGTT검측，이리우조기진단화방치당뇨병적발생，개선예후。
Objective:To determine the status of glucose intolerance in breast cancer patients without DM history after combined treatment with surgery and/or chemotherapy through an oral glucose tolerance test (OGTT). Methods:All 121 breast cancer patients more than 3 months after combined treatments with surgery and/or chemotherapy and without the diagnosis of diabetes underwent OGTT and fasting. Then, 2 h glucose levels were measured to identify glucose tolerance and diabetes. Meanwhile, six patients with a history of diagnosed diabetes did not undergo OGTT. Results:The median ages of all breast cancer patients and the mean duration after combined treatments with surgery and/or chemotherapy were 50.4 years and 19 months, respectively. Among the 121 breast cancer pa-tients without the history of diabetes, the incidences of diabetes, prediabetes, and normal glucose intolerance were 19.8%(24 cases), 45.5%(55 cases) and 34.7%(42 cases), respectively. Among all breast cancer patients, the incidences of previously diagnosed diabetes, undiagnosed diabetes, and prediabetes were 4.72%, 18.9%, and 43.3%, respectively. The ratio of previously undiagnosed diabetes was about 80%. About 80.0% of undiagnosed diabetes and 74.5% of prediabetes met the criteria for elevated 2 h plasma glucose levels through OGTT instead of elevated fasting glucose levels. Conclusion: Breast cancer patients during follow-up after combined treat-ments with surgery and/or chemotherapy highly suffer from glucose intolerance, with high incidences of undiagnosed diabetes and pre-diabetes. OGTT should be made for breast cancer patients after combined treatments for early diagnosis, prevention, and treatment of di-abetes.