Work

One-hour plasma glucose identifies metabolic subgroups in individuals with HbA1c-defined prediabetes and normal fasting and 2-hour glucose

Year: 2026

Type: article

Abstract: Background This study evaluated whether 1-hour postload glucose (1-h PG) identifies distinct metabolic subgroups with differing OGTT-derived β-cell function indices among Chinese adults with HbA1c-defined prediabetes and normal fasting and 2-hour glucose. Methods This cross-sectional study included 8,537 Chinese adults undergoing 75-g OGTT and HbA1c testing. Participants were stratified into four glycemic phenotypes based on HbA1c (≥5.7%) and OGTT criteria. Within the HbA1c+/OGTT− subgroup (n=922), individuals were further classified by 1-h PG (cutoff 8.6 mmol/L). β-cell function was assessed using the disposition index (DI). Linear mixed-effects models analyzed glucose and insulin dynamics. Results Among 3,800 individuals with prediabetes, 24.3% exhibited isolated HbA1c elevation (HbA1c+/OGTT−). Within this discordant subgroup, 51.8% had elevated 1-h PG (≥8.6 mmol/L). The 1-h PG+ subgroup demonstrated lower β-cell function (DI = 40.47), delayed glucose peaks (60 min), impaired early-phase insulin secretion, and greater overall glycaemic exposure, whereas the 1-h PG− subgroup exhibited preserved or enhanced β-cell function (DI = 85.19 vs. 75.56 in NGT, P < 0.001). Multivariable linear regression analysis demonstrated that 1-h PG remained significantly associated with β-cell function after adjustment for age, sex, and HbA1c. Conclusions Among individuals with HbA1c-defined prediabetes and normal Fasting and 2-Hour Glucose, 1-hour plasma glucose identifies subgroups with differing metabolic profiles and β-cell function. These findings highlight substantial metabolic heterogeneity within this population. However, given the cross-sectional design of the study, longitudinal investigations are required to determine whether these metabolic differences translate into differences in future diabetes risk and clinical outcomes. Trial registration Not applicable.

Source: BMC Endocrine Disorders

DOI: 10.1186/s12902-026-02485-7

Authors: Ling Ouyang, Qianwen Nie, Youyuan Huang, Xue Qiu, Aimei Dong

Institutions: Peking University First Hospital, Shenzhen University of Advanced Technology

Language: English

Topic: Diabetes, Cardiovascular Risks, and Lipoproteins

Subfield: Endocrinology, Diabetes and Metabolism

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,190