2型糖尿病血糖波动与糖化血红蛋白的相关性分析

The correlative analysis of serum glucose fluctuation and glycated hemoglobin in patients with type 2 diabetes

目的探讨2型糖尿病血糖波动与糖化血红蛋白的相关性。方法将286例2型糖尿病患者进行动态血糖监测(CGMS),根据血糖波动系数(BGFC)分为BGFC≤1.5组43例,1.5<BGFC<3.0组174例,BGFC≥3.0组69例,比较3组日内平均血糖(MBG),空腹平均血糖(MFBG),3餐后平均血糖水平(MPBG2h),不同血糖水平所占日内时间百分比(PT),糖化血红蛋白(Hb A1c),果糖胺(FFA),BGFC及各指标的相关性。结果各组MBG、MFBG、MPBG2h、高血糖(≥11.1mmol/L)时间比(PT11.1)、低血糖(≤3.9mmol/L)时间比(PT3.9)、Hb A1C、FFA均有统计学差异(P<0.05);以BGFC为因变量,多元线性逐步回归分析显示PT11.1、PT3.9、MBG、MFBG、Hb A1C、MPBG2h^(早)进入最后回归方程;以Hb A1c为因变量,多元线性逐步回归分析显示FFA、MBG、MPBG2h^(早)、BGFC进入最后的回归方程。结论 2型糖尿病患者血糖波动与Hb A1C密切相关,减少血糖波动,更有利于全面控制血糖,减少并发症的发生。

Objective To investigate the correlation of serum glucose fluctuation and glycated hemoglobin in patients with type 2 diabetes. Methods Continuous glucose monitoring system （CGMS） was applied to monitor glucose level in 286 patients with type 2 diabetes. All the patients were divided into three groups according to the level of blood glucose fluctuation coefficient （BGFC）：43 cases for BGFC ~〈 1.5, 174 cases for 1.5〈BGFC〈3.0 and 69 cases for BGFC ~ 3.0.Average blood glucose levels （MBG）,mean fasting blood glucose levels （MFBG）, average blood glucose levels after meals （MPBG2h）, and blood glucose levels were different represented of the percentage of days time （PT）. Glycated hemoglobin （HbA1c） and fructosamine （FFA） were compared in these three groups. BGFC and each obvious factor were in index correlation. Results There were significant differences between the level of MBG, MFBG,MPBG2h,PT11.1,PT3.9,HbA1c and FFA in each group （P〈0.05）. With BGFC score as the dependent variable and the indicators above as the independent variables,the multiple stepwise regression analysis showed that PT11.1, PT3.9,MBG,MFBG,HbAlc and MPBG2h （m） came into the final equation. With HbAlc score as the dependent variable and the indicators above as the independent variables, the multiple stepwise regression analysis showed that FFA,MBG,MPBG2h（m） and BGFC came into the final equation.Conclusion Blood glucose fluctuation is positively associated with HbAlc in patients with type 2 diabetes and reducing glucose fluctuation is more benefit to control glucose overall level and reduce diabetic complication.