2型糖尿病患者葡萄糖目标范围内时间与振动感觉阈值的相关性研究

Correlation of time in range and vibrating perception threshold in patients with type 2 diabetes mellitus

目的探讨T2DM患者葡萄糖目标范围内时间(TIR)与振动感觉阈值(VPT)的相关性。方法选取2018年8月至2021年4月于兰州大学第二医院老年病科住院的T2DM患者303例,根据VPT等级分为振动觉正常组(VSN,n=66)、振动觉减退组(VSI,n=95)及振动觉缺失组(VSD,n=142)。比较各组一般资料、生化指标及动态血糖监测指标。结果与VSN组比较,VSI、VSD组年龄、DM病程、FPG、2 hPG、HbA_(1)c、TG、胰岛素使用率升高(P<0.01),TC降低(P<0.01),VSD组吸烟史升高(P<0.05)。VSD组年龄、DM病程、HbA_(1)c、FPG、胰岛素使用率高于VSI组(P<0.01)。随着VPT等级升高,血糖高于目标范围时间(TAR)、最大血糖波动幅度(LAGE)、平均血糖标准差(SDBG)升高(P<0.01),TIR降低(P<0.01)。Spearman相关分析显示,VPT等级与年龄、DM病程、HbA_(1)c、TG、TAR、SDBG、LAGE呈正相关(P<0.01),与TIR呈负相关(P<0.01)。多元逐步回归分析结果显示,TIR是VPT的保护因素,年龄、DM病程、HbA_(1)c及TG是VPT的危险因素。结论TIR与VPT等级呈负相关,是VPT的保护因素。

Objective To explore the correlation between time in range(TIR)and vibration perception threshold(VPT)in patients with type 2 diabetes mellitus(T2DM).Methods A total of 303 patients with T2DM were collected in this study from Geriatric Department in the Second Hospital of Lanzhou University during August 2018 to April 2021.According to VPT,they were divided into vibration sensation normal group(VSN,n=66),vibration sensation impaired group(VSI,n=95)and vibration sensation deficiency group(VSD,n=142).The general clinical data,blood biochemical indicators and dynamic blood glucose monitoring indicators were compared among the three groups.Results Compared with VSN group,age,T2DM duration,FPG,2 hPG,HbA_(1)c,TG and insulin usage rate were higher,while TC was lower in VSI group and VSD group(P<0.01).Smoking rate was higher in VSD group(P<0.05).Age,T2DM duration,HbA_(1)c,FPG and insulin usage rate were higher in VSD group than in VSI group(P<0.01).With the increase of VPT grade,TIR decreased(P<0.01),while time above range(TAR),largest amplitude of glycemic excursion(LAGE)and standard deviation blood glucose(SDBG)increased(P<0.01).Spearman correlation analysis indicated that the grade of VPT was positively correlated with age,T2DM duration,HbA_(1)c,TG,TAR,SDBG,LAGE(P<0.01),and negatively correlated with TIR(P<0.01).Multiple stepwise regression analysis showed that TIR was an independent protective factor for VPT,but age,T2DM duration,HbA_(1)c and TG were independent risk factors for VPT.Conclusion TIR is negatively correlated with the grade of VPT,and is an independent protective factor for VPT.