2型糖尿病合并代谢相关脂肪性肝病患者应用持续葡萄糖监测的研究

Application of continuous glucose monitoring in metabolic associated fatty liver disease

目的探讨持续血糖监测(CGM)在T2DM合并代谢相关脂肪性肝病(MAFLD)患者中的应用。方法选取2017年10月至2020年10月于苏州大学附属第一医院内分泌科住院的T2DM患者148例,分为单纯T2DM组(T2DM,n=87)及T2DM合并MAFLD组(T2DM+MAFLD,n=61),比较两组一般资料及CGM相关指标。结果T2DM+MAFLD组BMI、谷丙转氨酶、谷草转氨酶、谷氨酰转肽酶、TG、二甲双胍用药比例及血糖高于目标范围时间(TAR)高于T2DM组(P<0.05),HDL-C及血糖目标范围内时间(TIR)低于T2DM组(P<0.05)。Pearson相关分析显示,MAFLD患者TIR与2 hC-P呈正相关(P<0.05),与DM病程、HbA1c、平均血糖波动幅度、血糖水平标准差、TAR呈负相关(P<0.05)。多元线性回归分析显示,TAR是MAFLD患者TIR的影响因素。结论MAFLD患者TIR降低,TAR升高,TAR是TIR的影响因素。

Objective To investigate the application of continuous glucose monitoring(CGM)in metabolic associated fatty liver disease(MAFLD).Methods A total of 148 hospitalized patients with T2DM were enrolled in this study from the Department of Endocrinology,The First Affiliated Hospital of Soochow University during October 2017 to October 2020,and divided into two groups:T2DM group(n=87)and T2DM+MAFLD group(n=61).Various anthropometric,biochemical characteristics and CGM metrics were measured and compared between the two groups.Results BMI,ALT,AST,GGT,TG,percentage of Metformin treatment and time above range(TAR)were significantly higher,while HDL-C and TIR were significantly lower in T2DM+MAFLD group than in T2DM group(P<0.05).Pearson correlation analysis showed that TIR was positively correlated with 2 hC-P(P<0.05),and negatively correlated with the duration of DM,HbA1c,MAGE,SD and TAR(P<0.05).Multiple linear regression analysis showed that TAR was an influencing factor for TIR in patients with MAFLD.Conclusion Patients with MAFLD have significantly lower TIR and higher TAR.TAR might be the independent influencing factors for TIR.