糖尿病肾病Ⅲ期患者的目标血糖范围与糖化血红蛋白、1,5-脱水葡萄糖醇和糖化血清白蛋白的相关性研究

Correlation among TIR, HbA1c,1, 5-AG, and GA in patients with 3rd stage of diabetic nephropathy

目的:探究糖尿病肾病Ⅲ期患者目标血糖范围(time in range,TIR)与糖化血红蛋白(hemoglobin A1c,HbA1c)、糖化血清白蛋白(glycated albumin,GA)和血清1,5-脱水葡萄糖醇(1,5-anhydroglucitol,1,5-AG)的相关性。方法:检测120例确诊糖尿病肾病Ⅲ期患者的HbA1c、1,5-AG和GA,运用扫描式动态血糖监测(flash glucose monitoring,FGM)观察患者的TIR,以TIR^3.9-10.0的70%为切点,观察≥70%组及<70%组的一般特征、实验室资料及FGM的血糖数据,总结TIR^3.9-10.0、HbA1c、1,5-AG和GA彼此之间的相关性。结果:TIR^3.9-10.0≥70%及TIR^3.9-10.0<70%的两组一般资料及实验室血糖监测指标以外的数据比较,差异无统计学意义(P>0.05)。在控制血红蛋白(hemoglobin,HGB)后,糖尿病肾病Ⅲ期患者TIR^3.9-10.0与糖化血红蛋白呈负相关(r=-0.871);控制估计肾小球滤过率(estimatedglomerularfiltrationrate,eGFR)后,TIR^3.9-10.0与1,5-AG浓度呈正相关(r=0.591);控制血清白蛋白后,TIR^3.9-10.0与GA浓度呈负相关(r=-0.521,P<0.05)。结论:糖尿病肾病Ⅲ期患者的TIR^3.9-10.0指标与HbA1c、1,5-AG及GA均具有相关性,可考虑作为早期糖尿病肾病患者短期血糖控制水平的评价指标。

Objective:To investigate the correlation among TIR,HbA1c,1,5-AG,and GA in patients with 3rd stage of diabetic nephropathy.Methods:HbA1c,1,5-AG,and GA were detected in 120 patients with 3rd stage of diabetic nephropathy and FGM was used to observe patients'TIR.The general characteristics,laboratory data and FGM blood glucose data of the groups≥70%and<70%of TIR^3.9-10.0 were observed,and the correlation among TIR^3.9-10.0,HbA1c,1,5-ag,and GA was summarized.Results:There was no significant difference in general information and laboratory data in addition toglycemicmonitoring indicators between the two groups of TIR3.9-10.0≥70%and TIR^3.9-10.0<70%(P>0.05).Afteradjusting HGB,TIR^3.9-10.0 was negatively correlated with HbA1c,r=-0.871;afteradjusting eGFR,TIR^3.9-10.0 was positively correlated with 1,5-AG concentration,r=0.591;after adjusting serum albumin,TIR^3.9-10.0 was negatively correlated with GA concentration,r=-0.521;all P values were less than 0.05.Conclusion:TIR^3.9-10.0 correlated with 1,5-AG,and GA in patients with 3rd stage of diabetic nephropathy,which can be considered as an evaluation index of short-term glycemic control in patients with early diabetic nephropathy.