老年2型糖尿病患者1，5-脱水葡萄糖醇与平均血糖及漂移幅度的相关性

Relationship of serum 1,5-anhydroglucitol with mean 24-hour blood glucose and glycemic excursion in aged patients with type 2 diabetes mellitus

目的研究老年2型糖尿病患者1,5-脱水葡萄糖醇（1,5-AG）与平均血糖（MBG）及漂移幅度的关系，探讨1,5-AG是否可作为糖尿病临床观察及治疗监控的指标之一。方法选取95例老年2型糖尿病住院患者，男性65例，女性30例，年龄70～88（80.1±4.3）岁，连续进行3d的动态血糖监测，统一进餐时间，期间记录每日参比血糖、饮食、服药及锻炼等活动事件。在第3天禁食8h以上，抽取空腹静脉血分别测定1,5-AG、糖化血红蛋白（HbA1c）、糖化血清蛋白（GSP）等数值。结果1,5-AG与空腹血糖、餐后2h血糖、HbAlc、GSP、3d MBG及平均血糖漂移幅度呈负相关（均P＜0.05），将1,5-AG与日内不同时段的MBG进行Pearson相关分析，显示其与早餐前1h、早餐后2h、早餐后3h、晚餐后2h、晚餐后3h及2∶00～4∶00的MBG呈负相关（均P＜0.05），与其他时段MBG相关性不明显。结论1,5-AG能较好地反映短时间内的MBG水平和血糖漂移，可作为糖尿病筛查和治疗监控的指标之一。

Objective To investigate the relationship of serum level of 1,5-anhydroglucitol （1,5-AG） with mean 24-hour blood glucose and glycemic excursion in the aged patients with type 2 diabetes mellitus （T2DM）, and to explore whether serum 1,5-AG can be used as one of the indicators for the clinical observation and treatment of the disease. Methods Totally ninety-five aged T2DM inpatients, 65 males and 30 females, with age ranging from 70 to 80 （80.1±4.3） years, who were admitted in our department from July 2009 to July 2012, were enrolled in this study. They were uniformed for their mealtime, and monitored for blood glucose for 3 consecutive days with a continuous glucose monitoring system （CGMS）. Their reference blood glucose, diet, times of taking medicine and doing exercises were recorded. Venous blood sample was collected on the 3rd day for the analysis of 1,5-AG, glycated hemoglobin （HbA1c）, and glycosylated serum protein （GSP） after 8 hours fasting. Results The serum level of 1,5-AG was negatively correlated with fasting blood glucose （FBG）, 2-hour postprandial blood glucose, HbA1c, GSP, mean blood glucose （MBG） within 3d, and mean amplitude of glycemic excursions （MAGE） （all P〈0.05）. Pearson correlation analysis indicated that the serum level of 1,5-AG had a negative correlation with MBG at the 6 time points of a day： 1h before breakfast, 2h after breakfast, 3h after breakfast, 2h after dinner, 3h after dinner, and 2∶00 am to 4∶00am （all P〈0.05）, but the level had no relation with MBG at other time points. Conclusion Serum level of 1,5-AG makes sound reflections of MBG and glycemic excursion within a short period, and can be considered as one of the indicators for diabetic screening and clinical monitoring for treatment.