老年2型糖尿病糖化血红蛋白与血糖波动的相关性分析

Correlation between HbA_1c and glucose fluctuation in elderly type 2 diabetic patients

目的研究老年2型糖尿病患者动态血糖波动与糖化血红蛋白(HbA1c)之间的相关性。方法 84例老年2型糖尿病患者均于入院后行动态血糖监测,并测定HbA1c水平,按HbA1c水平分为3组,Ⅰ组(HbA1c≤7.0%)20例、Ⅱ组(7.0%<HbA1c≤10%)39例、Ⅲ组(HbA1c>10%)25例,分析动态血糖波动与HbA1c的相关性,探讨夜间低血糖与睡前血糖的关系。结果 3组患者空腹血糖、餐后2小时血糖、低血糖比例Ⅱ组与Ⅰ组比较有统计学意义(P<0.05),Ⅲ组与Ⅱ组比较有统计学意义(P<0.05);3组平均血糖(MBG)、空腹平均血糖(MFBG)、早餐后2h平均血糖、中餐后2h平均血糖、晚餐后2h平均血糖与HbA1c均呈正相关(P均<0.01);平均血糖波动幅度、有效血糖波动次数、日间血糖平均绝对差随着HbA1c的增高也逐渐升高。多元线性回归分析显示HbA1c与血糖呈显著正相关(P<0.01)。夜间低血糖发生率16.8%,其中,睡前血糖最低值(7.2±3.4)mmol/L。结论老年2型糖尿病患者HbA1c与动态血糖水平显著相关,HbA1c与MBG相关性最好,睡前血糖在7.2mmol/L以下,夜间低血糖发生率高。

Objective To analyze the correlation of glucose fluctuation and glycosylated hemoglobin A1c （HbA1 c）in elderly type 2 diabetic patients.Methods A total of 84 elderly type 2 diabetic patients hospitalized in our department were enrolled in this study.The blood glucose of the enrolled subjects was performed by continuous glucose monitoring system and HbA1 c was examined in all the subjects.The subjects were divided into three groups by the HbA1 c level.GroupⅠhad 20 subjects （HbA1 c≤7.0%）,group Ⅱ 39 subjects （7.0%〈HbA1 c≤10.0%）,groupⅢ 25 subjects （HbA1 c〉10.0%）.Results The fasting blood glucose and 2-hour postprandial blood glucose level,and the proportion of hypoglycaemia of group Ⅱ showed significant difference as compared with those of group Ⅰ （P 〈0.05）,the indexes were statistically significant of group Ⅲ compared with group Ⅱ（P 〈0.05）.Mean blood glucose （MBG）,mean fasting blood glucose（MFBG）,and mean 2-hour postprandial blood glucose were significantly correlated with HbA1 c （P 〈 0.01 ）;HbA1 c increased with mean amplitude of glucose excursion,effective blood glucose fluctuations in frequency and absolute means of daily differences at the same time.Multiple linear regression analysis showed that HbA1 c was significantly correlated with blood glucose （P 〈0.01 ）.The incidence of hypoglycaemia at night was 1 6.8%,and the lowest blood glucose level before sleep was （7.2±3.4）mmol/L.Conclusion HbA1 c was significantly correlated with blood glucose in elderly type 2 diabetic patients,and HbA1 c was positive correlated with MBG.The incidence of hypoglycemia was higher during the night if blood glucose was under 7.2 mmol/L before sleep.