血糖波动与糖尿病大血管并发症的相关性

The relationship between glucose fluctuation and macrovascular complications in type 2 diabetes

目的分析糖尿病大血管并发症与血糖波动之间的关系。方法选取2型糖尿病(T2DM)患者作为研究对象,根据是否伴有大血管并发症分为大血管并发症组(66例)和无大血管并发症组(76例)。记录研究对象的一般临床资料、实验室指标及动态血糖监测(CGM)资料。结果 (1)大血管并发症组的年龄、DM病程、高血糖时间百分比、高血糖AUC、MBG、低血糖发生率、2h PPG、SDBG、MAGE、LAGE均显著大于或高于无大血管并发症组(P<0.05或P<0.01)。而两组间性别比例、吸烟史、高血压史、降糖药物使用情况、血脂、肝功、FPG及HbA1c等指标均无统计学差异。(2)逐步Logistic回归分析显示大血管并发症与年龄、MAGE呈独立正相关。(3)Spearman相关性分析显示大血管并发症与年龄、DM病程、高血糖时间百分比、高血糖AUC、低血糖发生率、MBG、2h PPG、SDBG、MAGE、LAGE均呈正相关。结论血糖波动指标MAGE与2型糖尿病患者大血管并发症相关。

AIM To investigate the relationship between glucose fluctuation and macmvascular complications in type 2 diabetes mellitus （T2DM）. METHODS Patients with T2DM were included in the study. The patients were divided into macrovascular complications group （66 cases） and non-macrovascular compli- cations group （76 cases）. General clinical data and laboratory indexes of the subjects were recorded. Continue glucose monitoring （CGM） was performed in both groups. RESULTS Age, duration of DM, the percentage of hyperglycemia, the area under curve （AUC） above 11.1 mmol/L, MBG, incidence of hypoglycemia, SDBG, MAGE and LAGE were higher in the macrovascular complications group than in the non-macrovascular complications group （all P 〈0.05 or P 〈 0. 01 ）. There was no significant differ- ence in the ratio of gender, smoker, hypertension, types of antidiabetic drugs, serum lipids, alanine aminotransferase, aspartate aminotransferase, FPG and HbAle between the two groups. Stepwise logistic regression analyses indicated that macrovaseular complications were positively related with age and MACE independently. Macrovascular complications were positively related with age, duration of DM, percentage of hyperglycemia, area under curve （ AUC ） above 11.1 mmol/L, incidence of hypoglycemia, MBG, 2hPPG, SDBG, MAGE and LACE using Spearman＇s correlation analysis. CONCLUSION Macrovas- cular complications were positively related with MAGE in type 2 diabetes mellitus.