2型糖尿病合并血管并发症患者纤维蛋白原水平的变化及其与血糖波动的相关性研究

Correlation of fibrinogen and glucose fluctuation in type 2 diabetic patients with vascular complications

目的探讨T2DM合并血管并发症患者的血糖波动与纤维蛋白原(FIB)的关系。方法选取2014年2月至2016年10月于我院内分泌科住院的T2DM患者1175例。根据有无合并血管并发症,分为T2DM组(n=424)和T2DM合并血管并发症组(n=751)。根据FIB四分位数分为4组,FIB≤2.53为Q1_(Fg)组,2.53<FIB≤3.06为Q2_(Fg)组,3.06<FIB≤3.79为Q3_(Fg)组,FIB>3.79为Q4_(Fg)组。比较各组间血糖波动相关指标,并进行回归分析。结果 (1)T2DM合并血管并发症组年龄、病程、SBP、FIB、最大血糖波动幅度(LAGE)、血糖水平标准差(SDBG)均高于T2DM组(P<0.05或P<0.01);(2)Q1_(Fg)～Q4_(Fg)组年龄、病程、SBP、HbA_1c水平、胰岛细胞β功能指数(HOMA-β)、血糖平均值(MBG)、LAGE和SDBG比较,差异有统计学意义(P<0.05或P<0.01),血管并发症发生率逐渐升高(62.32%vs 68.00%vs 72.08%vs 78.23%,P<0.05);(3)多元线性回归分析结果显示,年龄、HOMA-β、SDBG是糖尿病患者纤维蛋白升高的危险因素。Logistic回归分析结果显示,年龄、病程、FIB是糖尿病血管并发症的危险因素。结论 T2DM患者的血糖波动幅度大,FIB升高,可能增加糖尿病合并血管并发症的风险。

Objective To investigate the correlation between glucose variability and fibrinogen（FIB）in type 2 diabetic patients with vascular complications. Methods A total of 1175 hospitalized patients with type 2 diabetes（T2DM）were enrolled in this study in the endocrinology of our hospital from Feb 2014 to Oct 2016.All the subjects were divided into two groups：T2DM without complications and T2DM with vascular complications.Then the patients were divided into four groups according to the quartiles of FIB：Q1 Fggroup（FIB≤2.53）,Q2 Fg group（2.53FIB≤3.06）,Q3 Fg group（3.06FIB≤3.79）,Q4 Fggroup（FIB3.79）.G1 ucose variability and correlated indices were compared,and the regression analysis was done. Results（1）Age,the duration of diabetes,SBP,FIB,LAGE and SDBG were significantly higher in T2DM with vascular complications group than in T2DM without complications group（P〈0.05 or P〈0.01）;（2）There were significant differences in age,the duration of diabetes,DBP,HbA_1 c,HOMA-β,MBG,LAGE and SDBG among the four groups（P〈0.05 or P〈0.01）.The incidence of vascular complications increased from Q1 Fggroup to Q4 Fggroup（62.32% vs 68.00% vs 72.08% vs 78.23%,P〈0.05）;（3）Multiple regression analysis showed that age,HOMA-βand SDBG were independent risk factors for hyperfibrinogenemia.Logistic regression analysis showed that age,duration of diabetes,and FIB were the independent risk factors for diabetes mellitus vascular complications. Conclusion The high glucose variability and FIB in patients with T2DM were closely associated with the risk of diabetic vascular complications.