血糖波动与早期糖尿病肾病微量白蛋白尿的关系

The relationship between blood glucose excursions and microalbuminuria in early diabetic nephropathy

目的探讨血糖波动与早期糖尿病肾病微量白蛋白尿之间的关系。方法对40例尿白蛋白排泄率(UAER)≤20μg/min(正常白蛋白尿组)及40例UAER 20-199μg/min(微量白蛋白尿组)的2型糖尿病患者进行动态血糖监测(CGMS),然后比较两组患者的平均血糖、平均血糖波动振幅(MAGE)及血糖标准差(SDBG)。结果两组患者的平均血糖水平(11.07±1.94 mmol/L vs 10.45±1.90 mmol/L)无统计学差异;微量白蛋白尿组,血糖标准差(3.14±0.94 mmol/L vs 2.21±0.64 mmol/L)、平均血糖波动振幅(6.2±0.6 mmol/L vs 3.4±0.4 mmol/L)均高于正常白蛋白尿组,差异有统计学意义。结论血糖水平控制相当的2型糖尿病患者(糖化血红蛋白、平均血糖水平相当)中,合并早期糖尿病肾病-微量白蛋白尿组其血糖标准差、平均血糖波动振幅均大于正常白蛋白尿组。

Objective Aims To examine the relationship between blood glucose excursions and microalbuminuria in early diabetic nephropathy.Methods 80 Type 2 diabetic patients（40 UAER≤20 μg/min,40 UAER 20-199 μg/min） wore continuous glucose monitoring systems for 3 days.The average glucose,mean amplitude of glycaemic excuisions（MAGE） and the standard deviation of blood glucose（SDBG） were calculated.Results There was no difference in the mean glucose between both groups,the diabetic nephropathy group had a greater MAGE（6.2±0.6 mmol/l vs 3.4±0.4 mmol/l）and a greater SDBG（3.14±0.94 mmol/l vs 2.21±0.64 mmol/l）.Conclusion Patients with early diabetic nephropathy have greater glucose excursion compared with patients who have no urinary microalbuminuria.