成都地区糖耐量正常者血糖水平变化的特征分析

Glycemic Excursions in People with Normal Glucose Tolerance in Chengdu

目的探讨成都地区糖耐量正常(NGT)者血糖水平变化特征。方法纳入50例NGT(男、女各25例)受试者,采用动态血糖监测系统(CGMS)进行连续72h血糖监测,分析日内平均血糖水平(MBG)、平均血糖波动幅度(MAGE)、日内血糖波动最大幅度(LAGE)、餐后血糖峰值(PPG)、餐后血糖波动幅度(PPGE)、三餐PPGE的均值(MPPGE)、日间血糖平均绝对差(MODD)、血糖波动的时间百分比。结果受试者血糖水平呈波动性变化,夜间及3餐前是血糖较低时段,日内血糖高峰多于餐后1～2h显现,尤以中、晚餐后为甚,且老年人群午餐后血糖波动幅度最大;本组NGT者MBG(5.9±1.2)mmol/L,MAGE(1.7±0.7)mmol/L,LAGE(4.4±1.9)mmol/L,PPG(8.7±1.7)mmol/L,MPPGE(2.3±1.6)mmol/L,MODD(0.75±0.79)mmol/L;78%(39例)的受试者血糖波动>7.8mmol/L,10%(5例)的血糖波动<2.8mmol/L,血糖波动于4.1～8.8mmol/L所占的日内时间百分比为95%(77%～100%)。结论成都地区NGT受试者存在血糖波动,CGMS有助于观察血糖波动并及时发现高血糖和无症状的低血糖。

Objective To investigate the characteristics of glycemic excursions in people with normal glucose tolerance （NGT） in Chengdu. Methods A total of 50 non-obese people with normal glucose tolerance（NGT, 23- 68years old）, normal blood pressures and lipid profiles participated in the study. The fluctuations of glucose levels in the participants were measured by a continuous glucose monitoring system （CGMS） for three days 72 h. The 48 h mean blood glucose （MBG）, mean amplitude of glycemic excursions （MAGE）, Largest amplitude of glycemie excursions （LAGE）, Postprandial peak glucose （PPG）, Postprandial glucose excursion （PPGE）, Mean of postprandial glucose excursion （MPPGE）, and absolute means of daily differences （MODD） were measured. Results The number of glucose values detected by CGMS amounted to 861± 7 with a mean absolute difference （MAD） of 11.3% ± 10. 6%. The CGMS values were significantly correlated with the capillary glucose measurements （n= 1076, r=0. 761, P〈0. 005）. The participants had a MBG of （5.9±1.2） mmol/L, a MAGE of （1.7±0.7） mmol/ L, a LAGE of （4.4±1. 9） retool/L, a daily glycemic peak （PPG） of （8.7±1. 7） mmol/L, a nadir level of （4.3± 0.7） mmol/L, a MPPGE of （2. 35±1. 6） mmol/L, and a MODD of （0. 75±0. 79） mmol/L. The post-breakfast Postprandial glycemic excursions （PPGE） were lower than those of post-lunch and post-dinner（P= 0.01 and P= 0.05）. The postprandial glucose excursions in the 60-70 year-old participants were the highest （P〈0. 022）. In 95 % （77%-100%） of the daytime, the glycose levels fluctuated between 4. 1 and 8. 8 mmol/L, and 78% of the participants （n=39） had hyperglycemia （BG〉7.8 mmol/L） and 10% （n=5） had asymtomatic hypoglycemia （BG 〈2. 8 mmol/L）. Conclusion CGMS tests may be important for detecting asymptomatic hyperglycemia and hypoglycemia. The NGT people in Chengdu have exhibited abnormal blood glucose values in CGMS, revealing problems in people with normal range of blood glucose.