2型糖尿病合并高血压患者葡萄糖在目标范围内时间与左心室质量指数的相关性研究

Study on correlation between time within glucose target range and left ventricular mass index in patients with type 2 diabetes mellitus complicating hypertension

目的研究2型糖尿病(T2DM)合并高血压患者葡萄糖在目标范围内时间(TIR)与左心室质量指数(LVMI)的相关性。方法选取2022年1-12月明光市人民医院住院T2DM患者102例作为研究对象,行连续动态葡萄糖监测,依据TIR水平,TIR≤40%者纳入A组(n=31),TIR>40%~70%者纳入B组(n=41),TIR>70%者纳入C组(n=30),收集3组患者的临床资料、实验室指标和超声心动图参数并进行比较。结果与A组比较,C组年龄、病程、收缩压、糖化血红蛋白(HbA1c)、静脉血浆空腹血糖(FPG)、血肌酐(SCr)和甘油三酯(TG)降低,高密度脂蛋白胆固醇(HDL-C)升高,差异有统计学意义(P<0.05)。与B组比较,C组年龄、SCr、TG、HDL-C、HbA1c和FPG降低,差异有统计学意义(P<0.05)。与A组和B组比较,C组左心房内径(LAD)、左室后壁厚度(LVPW)、室间隔厚度(IVS)和LVMI降低,差异有统计学意义(P<0.05)。多元线性逐步回归分析结果显示,TIR是LVMI的保护因素(OR=0.562,95%CI:0.413~0.673,P<0.05),病程和收缩压是危险因素(OR=1.511,95%CI:1.067~2.947;OR=2.325,95%CI:1.086~5.574,P<0.05)。结论T2DM合并高血压患者的TIR与LVMI相关,TIR可能是心血管早期事件的影响因素。

Objective To investigate the correlation between the glucose time in range(TIR)and left ventricular mass index(LVMI)in the patients with type 2 diabetes mellitus(T2DM)complicating hypertension.Methods A total of 102 inpatients with T2DM in the Mingguang Municipal People’s Hospital from January to December 2022 were selected as the study subjects and conducted the continuous dynamic glucose monitoring.They were divided into the group A(TIR≤40%,n=31),group B(TIR>40%-70%,n=41)and group C(TIR>70%,n=30)according to the TIR level.The clinical data,laboratory indicators and echocardiographic parameters were collected and compared among the three groups.Results Compared with the group A,the age,disease course,systolic blood pressure and the levels of HbA1c,FPG,SCr and TG in the group C were significantly decreased,the HDL-C level was increased,and the differences were statistically significant(P<0.05).Compared with the group B,the age and the levels of SCr,TG,HDL-C,HbA1c and FPG in the group C were decreased,and the differences were statistically significant(P<0.05).Compared with the group A and group B,LAD,LVPW,IVS and LVMI in the group C were reduced with statistical differences(P<0.05).The multiple linear stepwise regression analysis results showed that TIR was a protective factor for LVMI(OR=0.562,95%CI 0.413-0.673,P<0.05),and the disease course and systolic blood pressure were the risk factors(OR=1.511,95%CI:1.067-2.947;OR=2.325,95%CI:1.086-5.574,P<0.05).Conclusion TIR in the patients with T2DM complicating hypertension is correlated with LVMI,and the TIR level may be an influencing factor for early cardiovascular events.