老年糖尿病患者不同糖化血红蛋白水平与全天血糖水平的相关性分析

Correlation analysis of different glycosylated hemoglobin levels and whole day blood glucose levels in the elderly diabetic patients

目的:探讨老年2型糖尿病患者不同糖化血红蛋白与日内不同时段血糖水平的相关性。方法:收集2013年1月至2014年1月住院的老年2型糖尿病患者120例,用毛细血管血糖监测2个月(第1个月4点血糖,第2个月7点血糖),同时在第2个月末监测糖化血红蛋白水平、血脂和肾功能,并根据糖化血红蛋白水平将患者分成A组(≤7%)68例、B组(7%~8%)33例和C组(≥8%)19例。分析患者不同性别、不同水平糖化血红蛋白与日内不同时段血糖、血脂、肾功能之间的关系。结果:三组总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL-C)、肌酐(Cr)、尿素氮(BUN)水平检测显示,B组均大于A组(P<0.05),C组大于A、B组(P<0.05)。三组糖化血红蛋白、早餐后、午餐前、晚餐后血糖水平B组均大于A组,C组大于A、B组(P<0.05);在空腹、晚餐前及睡前血糖测定显示,C组大于A、B组(P<0.05),A、B组间无差异。经Pearson检验糖化血红蛋白与不同时段血糖、肾功能、血脂呈正相关性(P<0.01),而与病程、年龄、性别无相关性(P>0.05)。除年龄外,不同性别之间的糖化血红蛋白、肾功能、血脂、病程差异均无统计学意义(P>0.05)。结论:老年2型糖尿病患者糖化血红蛋白与各时段血糖呈正相关性,亦与肾功能、血脂呈正相关性,除空腹、睡前血糖外,余日内各时段血糖、LDL-C、TG、TC及肾功能均随糖化血红蛋白水平升高而逐渐升高。因此,控制血糖的同时要对血脂、肾功能进行监测和干预治疗。

Objective:To investigate the association between different glycosylated hemoglobin and blood glucose levels in different periods of the day in the elderly patients with type 2 diabetes.Methods:One hundred and twenty elderly patients with type 2 diabetes who were hospitalized from January 2013 to January 2014 were collected,blood glucose was monitored by capillary blood glucose for 2 months(four times blood glucose in the first month and seven times blood glucose in the second month),meanwhile,glycosylated hemoglobin level,blood lipids and renal function were monitored at the end of the second month and according to glycosylated hemoglobin levels they were divided into group A(≤7%)with 68 cases,group B(7%~8%)with 33 cases,and group C(≥8%)with 19 cases.The relationship between blood glucose,blood lipid and renal function of patients with different gender and different levels of glycosylated hemoglobin were analyzed.Results:The levels of total cholesterol(TC),triglycerides(TG),low-density lipoprotein(LDL-C),creatinine(Cr),and urea nitrogen(BUN)in the three groups showed that group B was greater than group A(P<0.05)and group C was larger than group A and group B(P<0.05).The blood glucose levels of glycosylated hemoglobin,after breakfast,before lunch,and after dinner showed that group B was greater than group A,and group C was greater than group A and group B(P<0.05);the blood glucose measurement on an empty stomach,before dinner and before going to bed showed that group C was greater than groups A and B(P<0.05),and there was no difference between groups A and B.According to Pearson’s test,glycosylated hemoglobin was positively correlated with blood glucose,renal function,and blood lipids at different times(P<0.01),but had no correlation with the course of disease,age,and gender(P>0.05).Except for age,there were no statistically significant differences in glycosylated hemoglobin,renal function,blood lipids,and disease course between different sexes(P>0.05).Conclusion:In elderly patients with type 2 diabetes,glycosylated hemoglobin is positively correlated with blood glucose at various times,and it is also positively correlated with renal function and blood lipids,and except for fasting and blood glucose before going to bed,blood glucose,LDL-C,TG,TC and renal function all increased gradually with the increase of glycosylated hemoglobin level during the rest of the day.Therefore,the control of blood glucose should be accompanied by blood lipids,renal function monitoring and intervention treatment.