T2DM患者血糖波动与DR及血清VEGF的关系

Relationship of Glycaemic fluctuation with diabetic retinopathy and serum VEGF level in Type 2 diabetes

目的:探讨糖化血红蛋白(HbA1c)<7%的2型糖尿病患者血糖波动与糖尿病视网膜病变和血清中血管内皮生长因子(VEGF)水平的关系。方法:应用动态血糖监测系统(CGMS)对50例T2DM患者进行连续72h血糖监测并计算平均血糖标准差(SDBG),平均血糖波动幅度(MAGE),日内最大血糖波动幅度(LAGE),日间血糖平均绝对差(MODD);应用ELISA法检测血清VEGF水平;根据眼底照相及眼底血管荧光造影结果进行视网膜病变分期。结果:1各组间血清VEGF水平有统计学意义(P<0.05);2DR组SDBG、MAGE、LAGE、MODD均高于非DR组和对照组。结论:血糖波动可能通过升高VEGF水平而参与T2DM患者视网膜病变进展,VEGF可作为判断T2DM患者视网膜病变发生发展的指标之一。

Objective: To investigate the relationship of bloodglucose fluctuation with the development of diabetic retinopathy and serum vascular Endothelial Growth Factor(VEGF) level in Type 2 diabetes with glycosylated hemoglobin(HbA1c)<7%.Methods: The blood glucose level was monitored for 72h by using continuous glucose monitor system(CGMS) and the standard deviation of mean blood glucose(SDBG),mean amplitude of glycaemic excursions(MAGE),large stamplitude of glycemic excursions(LAGE) and absolute means of daily difference(MODD) were calculated in 50 cases of Type 2 diabetes with HbA1c<7%.The serum VEGF level was detected by ELISA in all the cases and 25 controls.Diabetic retinopathy was diagnosed by the result of eye ground photography and opacification.Results:①the serum VEGF level in diabetes with retinopathy was significantly higher than that in diabetes without retinopathy and controls(P<0.05);②The course of disease,PPG,SDBG,LAGE,MAGE and MODD levels in patients with retinopathy were significantly higher than those in patients without retinopathy(P<0.05).Conclusion: The large amplitude glycemic fluctuation may accelerate the progression of DR by increasing the VEGF level that can become a index for the judgment of the development of DR.