摘要
急性高海拔暴露初期常引发应激性高血糖,主要与交感-肾上腺系统及下丘脑-垂体-肾上腺皮质轴激活、应激激素释放增加、胰岛素敏感性下降及肝糖原输出增多相关。长期居住于高海拔地区的人群,多数研究显示其基础血糖水平呈现降低趋势,部分研究提示2型糖尿病患病风险降低,但存在显著的地域异质性。潜在机制涉及肝脏葡萄糖输出减少、外周组织葡萄糖摄取利用增强,以及肠道菌群与代谢组重塑。高海拔环境对便携式血糖仪测量的准确性构成挑战,推荐使用标准化实验室血浆葡萄糖测定。遗传适应、环境因素及生活方式等混杂因素对观察到的关联具有重要影响。未来需开展设计严谨、标准化测量、并全面控制混杂因素的大型队列研究。
In the early stage of acute high-altitude exposure,stress-induced hyperglycemia often occurs,which is mainly associated with the activation of the sympathetic-adrenal system and hypothalamic-pituitary-adrenal axis,increased release of stress hormones,decreased insulin sensitivity,and enhanced hepatic glycogen output.For populations living at high altitudes for a long time,most studies have shown a tendency toward reduced basal blood glucose levels,and some studies suggest a decreased risk of type 2 diabetes,but there is significant geographical heterogeneity.The potential mechanisms involve reduced hepatic glucose output,enhanced glucose uptake and utilization in peripheral tissues,as well as remodeling of the gut microbiota and metabolome.The high-altitude environment poses challenges to the accuracy of portable blood glucose meter measurements,and standardized laboratory plasma glucose determination is recommended.Confounding factors such as genetic adaptation,environmental factors,and lifestyle have a significant impact on the observed associations.In the future,large-scale cohort studies with rigorous design,standardized measurements,and comprehensive control of confounding factors are needed.
作者
巴合加玛力·努尔波拉提
骆秦
Bahejiamali Nuerbolati;LUO Qin(Graduate School of Xinjiang Medical University,Urumqi,830001,China;Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region,Key Laboratory of Hypertension Diagnosis and Treatment Research,National Health Commission,Urumqi,830001,China)
出处
《新疆医学》
2025年第9期1132-1136,共5页
Xinjiang Medical Journal
基金
新疆维吾尔自治区重点研发计划项目(项目编号:2022B03009)。
关键词
海拔
葡萄糖稳态
糖尿病
高原适应
低氧
流行病学
机制
Altitude
Glucose homeostasis
Diabetes mellitus
High-altitude adaptation
Hypoxia
Epidemiology
Mechanism
