摘要
目的探讨血糖波动对2型糖尿病患者颈动脉粥样硬化的影响。方法应用超声仪检测82例2型糖尿病患者颈动脉内-中膜厚度(CIMT),以CIMT=0.9 mm为切点,分为未合并颈动脉粥样硬化组(A组,36例,CIMT<0.9 mm)和合并颈动脉粥样硬化组(B组,46例,CIMT≥0.9mm),对两组患者行72小时动态血糖监测,检测相关指标,并将其与CIMT进行相关性分析。结果1 B组患者年龄、收缩压(SBP)、低密度脂蛋白胆固醇(LDL-C)、日内平均血糖波动幅度(mean amplitude of glycemic excursion,MAGE)、血糖标准差(standard deviation of blood glucose,SDBG)、最大血糖波动幅度(largest amplitude of glycemic excursion,LAGE)、平均餐后血糖波动幅度(mean postprandial glucose excursion,MPPGE)、血清同型半胱氨酸(Hcy)、CIMT、胰岛素抵抗指数(HOMA-IR)较A组均升高,差异具有显著性(P<0.05);2 CIMT与LDL-C、Hcy、MAGE、SDBG、LAGE、MPPGE密切相关(P<0.05);3多因素逐步回归分析发现:MAGE、Hcy、HOMAIR与CIMT独立相关(Y=0.094 MAGE+0.025 Hcy+0.440 HOMA-IR-0.039)。结论血糖波动与2型糖尿病颈动脉粥样硬化密切相关,是颈动脉粥样硬化的独立危险因素。
Objective To investigate the effect of glucose excursion on the impact of patients with carotid artery atherosclerosis（CAS） in type 2 diabetes mellitus（T2DM）. Method The carotid intima-media thickness（CIMT） of 82 patients with T2 DM were detected by high frequency of color ultrasonic Doppler. The patients were divided into T2 DM unconsolidated CAS（group A, n = 36, CIMT 0.9 mm） and T2 DM consolidated CAS（group B, n = 46, CIMT ≥ 0.9 mm） according to CIMT = 0.9 mm of cut-off point. Fluctuations in blood glucose levels were measured over 72 hours by continuous glucose monitoring system（CGMS） and related indicators were detected. Its correlations with CIMT were analyzed. Result 1 The difference of age, systolic blood pressure（SBP）, low-density lipoprotein cholesterol（LDL-C）, mean amplitude of glycemic excursions（MAGE）, standard of blood glucose（SDBG）, largest amplitude of glycemic excursions（LAGE）, mean postprandial glucose excursion（MPPGE）, homocysteine（Hcy）, CIMT, index of insulin（HOMA-IR） in the two groups were statistically significant（P〈0.05）; 2 CIMT was closely related to LDL-C, Hcy, MAGE, SDBG, LAGE and MPPGE（P〈0.05）; 3 Multiple stepwise regression analysis indicated that MAGE, Hcy, HOMA-IR were dependent correlated with CIMT（Y = 0.094 MAGE ＋ 0.025 Hcy ＋ 0.440 HOMA-IR- 0.039）. Conclusion Glucose excursion are closely associated with CAS in patients with T2 DM,which are independent risk factors of CAS.
出处
《中国医学前沿杂志（电子版）》
2015年第5期28-31,共4页
Chinese Journal of the Frontiers of Medical Science(Electronic Version)
基金
国家科技重大专项子课题(2011ZX09307-001-08)
