2型糖尿病患者糖化血红蛋白与血糖波动相关性的观察

Correlation between the HbA_1c level and glucose fluctuation in T2DM patients

目的探讨以HbA1c作为评价血糖控制状况的指标所反映T2DM患者血糖的控制情况。方法对52例T2DM患者行72h动态血糖监测,按HbA1c值分为<7.0%(A组)、7.0%≤HbA1c<10%(B组)、≥10%(C组)。结果 (1)3组患者平均血糖波动幅度(MAGE)、早餐后高血糖曲线下面积、夜间低血糖曲线下面积、早餐及午餐后高血糖持续时间、夜间低血糖持续时间、三餐前后血糖漂移差异无统计学意义(P>0.05),平均血糖、血糖标准差、血糖最大波动幅度、午餐及晚餐后高血糖曲线下面积、午餐后高血糖持续时间差异有统计学意义(P<0.05)。(2)多重线性回归分析显示,以HbA1c为因变量只有平均血糖进入了最终方程;以平均血糖波动幅度为因变量,只有血糖标准差和晚餐后高血糖曲线下面积进入了最终方程。结论 HbA1c主要反映平均血糖,平均血糖波动幅度主要反映血糖变异性,两者反映了血糖控制的不同方面。

Objective To investigate the glycemic control of the T2DM patients by HbA1 c levels. Methods Fifty-two T2DM patients were observed with 72 h continuous glucose monitoring system, and they were divided into groups A, B, and C based on the level of HbA1 c 〈7. 0%, 7. 0%≥ HbA1 c〈10%, and ≤10 % respectively. Results （1） The mean amplitude of glycemic excursions （MAGE）, area under the curve of breakfast hyperglycemia, area under the curve of night hypoglycemia, duration of breakfast and lunch hyperglycemia, duration of night hypoglycemia, and postprandial glycemic excursion among the three groups were not statistically different （P〉0. 05）, while the mean blood glucose, blood glucose standard deviation, largest amplitude of glycemic excursion, area under the curve of lunch and supper hyperglycemia, and duration of lunch hyperglycemia were statistically different between the three group （P〈0.05）. （2） The multiple linear regression analysis showed that when HbAlc was a dependent variable, the mean blood glucose came into the final equation, and when MAGE was the dependent variable, the blood glucose standard deviation and area under the curve of supper hyperglycemia came into the final equation. Conclusion HbAlc mainly reflects the average level of blood glucose, and MAGE mainly distinguishes the blood glucose variability. Both two reflect the glycemic control from different aspects.