血糖控制目标范围内时间与糖尿病视网膜病变的相关性分析

Correlation between time in range of blood glucose and diabetic retinopathy

目的:探究血糖在目标范围内时间(TIR)与糖尿病视网膜病变(DR)的相关性。方法回顾性分析2019年6月至2021年2月南方医科大学顺德医院收治的138例糖尿病患者的临床资料,根据是否发生DR分为两组,其中27例发生DR患者为DR组,111例未发生DR患者为非DR组。比较不同DR分期TIR水平,分析TIR与HbA1c、DR分期的相关性,评估TIR、HbA1c对DR的预测价值。结果两组性别、年龄、体质量指数、糖尿病病程、收缩压(SBP)、舒张压(DBP)、空腹血糖(FPG)、餐后2小时血糖(2 h PG)、空腹C肽、餐后2小时C肽、总胆固醇(TC)、甘油三脂(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、尿微量白蛋白比较,差异无统计学意义(P>0.05)。DR组HbA1c水平高于非DR组,TIR低于非DR组(P<0.05)。HbA1c、TIR为DR发生的相关因素(P<0.05);非增殖期患者TIR高于增殖期患者(P<0.05);TIR与HbA1c、DR分期呈负相关(P<0.05);ROC曲线结果显示,TIR预测发生DR的AUC大于HbA1c(P<0.05)。结论TIR与DR的发生密切相关,通过动态监测其水平可对糖尿病患者是否发生DR进行预测,给临床治疗方案的制定提供依据。

Objective:To explore the correlation between time in range(TIR)of blood glucose and diabetic retinopathy(DR).Methods The clinical data of 138 diabetic patients admitted to Southern Medical University Shunde Hospital between June 2019 and February 2021 were retrospectively enrolled and divided into two groups according to presence of DR.The DR group consisted of 27 patients,and the non-DR group consisted of 111 patients.The two groups were compared for the length of TIR according to DR staging.The correlation between TIR,HbA1c and DR staging was analyzed.The predictive value of TIR and HbA1c for DR was evaluated.Results The two groups did not differed signficantly in gender,age,body mass index,diabetes duration,systolic blood pressure(SBP),diastolic blood pressure(DBP),fasting plasma glucose(FPG),2-hour postprandial glucose(2h PG),fasting and 2-hour postprandial C-peptide,total cholesterol(TC),triglycerides(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),and urine microalbumin(P>0.05).The DR group showed higher HbA1c level and shorter TIR compared with the non-DR group(P<0.05).The HbA1c and TIR were factors related to DR(P<0.05).The TIR in non-proliferative DR patients was longer than that in proliferative DR patients(P<0.05).TIR was negatively correlated with HbA1c level and DR staging(P<0.05).ROC curve showed a greater AUC with TIR than with HbA1c in predicting DR(P<0.05).Conclusion TIR is closely related to occurrence of DR.Serial monitoring of TIR can predict DR in diabetic patients and ground the formulation of clinical treatment strategy.