2型糖尿病患者葡萄糖目标范围内时间与糖尿病并发症、合并症相关性的研究

Association of time in range with diabetic complications in type 2 diabetes mellitus patients

目的探讨T2DM患者葡萄糖目标范围内时间(TIR)与DM并发症、合并症的相关性。方法选取2017年6月至2021年7月于河南省人民医院内分泌科住院治疗的T2DM患者523例,根据TIR四分位数分为TIR Q1组(n=136)、TIR Q2组(n=146)、TIR Q3组(n=122)及TIR Q4组(n=119)共4个组。Spearman相关分析住院费用与其他指标的相关性,Logistic回归分析糖尿病周围神经病变(DPN)、DKA、脑梗死的影响因素。结果与TIR Q1组比较,TIR Q4组DM病程、HbA_(1)c、变异系数(CV)、标准差(SD)、平均血糖波动幅度(MAGE)、葡萄糖低于目标范围时间、葡萄糖高于目标范围时间、住院费用、DPN患病率、DKA患病率、脑梗死患病率降低(P<0.05)。Spearman相关分析显示,住院费用与年龄、DM病程、HbA_(1)c、CV、SD、MAGE、DPN、DKA呈正相关(P<0.05),与TIR呈负相关(P<0.05)。多元线性回归分析显示,TIR、DM病程、HbA_(1)c是住院费用的影响因素。Logistic回归分析显示,TIR Q1是DPN、DKA、脑梗死的影响因素。结论T2DM患者TIR与DPN、DKA、脑梗死、住院费用显著相关,TIR水平越低,DPN、DKA、脑梗死患病率及住院费用越高。

Objective To investigate the correlation between time in range(TIR)assessed by continuous glucose monitoring(CGM)and diabetic complications in with type 2 diabetes mellitus(T2DM).Methods 523 T2DM patients hospitalized in the Endocrinology Department of Henan Provincial People's Hospital from June 2017 to July 2021 were selected and divided into four groups(TIR Q1,TIR Q2,TIR Q3 and TIR Q4)based on TIR quartile.Spearman correlation analysis was used to anaylze the correlation between hospitalization expenses and other indicators.Logistic regression analysis was used to anaylze the influencing factors of diabetes peripheral neuropathy(DPN),DKA and cerebral infarction.Results Compared with TIR Q1 group,DM duration,HbA_(1)c,coefficient variation(CV),standard deviation(SD),mean amplitude glycemic excursions(MAGE),time of glucose below target range,time of glucose above target range,hospitalization expenses,incidence of DPN,DKA and cerebral infarction in TIR Q4 group decreased(P<0.05).Spearman correlation analysis showed that hospitalization expenses were positively correlated with age,DM duration,HbA_(1)c,CV,SD,MAGE,DPN and DKA(P<0.05),and negatively correlated with TIR(P<0.05).Multiple linear regression analysis showed that TIR,DM duration and HbA_(1)cwere the influencing factors of hospitalization expenses.Logistic regression analysis showed that TIR Q1 is an influencing factor for DPN,DKA and cerebral infarction.Conclusion Stable blood glucose control can help reduce the incidence of DPN,DKA and cerebral infarction in T2DM patients,and reduce the costs of hospitalization.