2型糖尿病患者血糖波动与踝肱指数的相关性

The correlation between glycemic variability and ankle-brachial index in type 2 diabetes mellitus patients

目的研究2型糖尿病(T2DM)患者血糖波动与踝肱指数(ABI)的相关性。方法根据ABI值将162例T2DM患者分为3组:A组44例,ABI≤0.9;B组103例,0.9<ABI≤1.3;C组15例,ABI>1.3。所有患者均采用动态血糖监测系统连续监测72 h血糖,计算平均血糖水平(MBG)及标准差(SD)、日内平均血糖波动幅度(MAGE)、变异系数(CV),并记录一般临床资料。结果与B组比较,A、C组患者的年龄、病程、低密度脂蛋白-胆固醇(LDL-C)、糖化血红蛋白(HbA1c)的差异均有统计学意义(均P<0.05);A组的MBG、SD、MAGE和CV值均明显高于B组(均P<0.05);ABI与年龄、病程、HbA1c、MAGE、SD均成负相关(均P<0.05),Logistic回归分析示患者年龄、病程、MAGE是ABI的独立影响因素。结论血糖波动是ABI的危险因素,有可能增加糖尿病下肢动脉病变风险,需重视动态血糖监测。

Objective To investigate relation between glycemic variability and ankle-brachial index(ABI) in type 2 diabetes mellitus(T2DM) patients.Methods According to ABI,162 patients were divided into three groups: group A with low ABI(ABI≤0.9),group B with normal ABI(0.9<ABI≤1.3),group C with high ABI(ABI>1.3).All patients underwent continuous glucose monitoring system(CGMS) measurement for 72 h,then the mean blood glucose(MBG) level and standard deviation(SD),mean amplitude of glucose excursions(MAGE) and coefficient of variation(CV) were calculated.Clinical parameters were also recorded.Results Compared with group B,patients in group A and group C showed older age,longer course of diabetes,higher level of LDL-C and HbA1c(all P<0.05).The value of MBG,SD,MAGE and CV in group A were higher than those in group B(all P<0.05).Analysis showed ABI was negatively correlated with age,course,HbA1c,MAGE and SD(all P<0.05).Logistic regression analysis revealed that age,course and MAGE were independent risk factors for low ABI(all P<0.05).Conclusion Glycemic variability was the risk factor of lower ABI and CGMS which must be carefully monitored.