摘要
目的对于2型糖尿病(T2DM)患者血糖波动与体重指数的相关性鲜有报道。文中旨在通过比较不同体重指数的T2DM患者血糖波动的差异性,评估血糖波动与体重指数(BMI)相关性。方法收集2017年6月至2018年10月东部战区总医院收治672例T2DM患者作为研究对象,根据BMI的四分位将患者分为4组,收集各组患者年龄、身高、体重、糖尿病病程、血红蛋白、尿酸、糖化血红蛋白等指标,以及改良稳态模型评估的胰岛素抵抗指数(HOMA-IR)及胰岛β细胞功能指数(HOMA-β)。通过佩戴动态血糖监测系统(CGMS)连续监测患者3 d内的血糖情况,计算血糖水平标准差(SBDG)、日间血糖平均绝对差(MODD)及平均血糖波动幅度(MAGE),分析BMI对血糖波动的影响。结果血糖波动指标与BMI、HbA1c、HOMA-β均呈负相关,而与HOMA-IR呈正相关。与BMI第1、2四分位组相比,第3、4四分位组的患者血糖波动水平降低。多因素Logistic回归分析显示,校正年龄、性别、胆固醇、三酰甘油、血红蛋白后,与第1四分位组比较,第4四分位组患者发生高血糖波动的风险减少(OR=0.594,95%CI:1.825~2.062)。结论T2DM患者血糖波动与BMI有关。较大BMI患者的血糖波动幅度更低。
Objective There are few reports on the correlation between blood glucose fluctuation and body mass index(BMI)in patients with type 2 diabetes mellitus(T2DM).This study aims to evaluate the correlation between the two by comparing the differences of glucose fluctuation in T2DM patients with different BMI.Methods A total of 672 patients with T2DM admitted to the General Hospital of Eastern Theater Command from June 2017 to October 2018 were selected as subjects.They were divided into 4 groups according to the quartile of BMI.The age,height,weight,course of diabetes,hemoglobin,uric acid,glycosylated hemoglobin,HOMA-IR(insulin resistance index)and HOMA-β(isletβcell function index)were collected.The blood glucose of the patients was continuously monitored within 3 days by wearing a continuous glucose monitor(CGMS).The standard deviation of daily blood glucose(SBDG),the mean of daily differences(MODD)and the mean amplitude of glycemic excursion(MAGE)were calculated to analyze the effect of BMI on blood glucose fluctuation.Results The index of blood glucose fluctuation was negatively correlated with BMI,HbA1c and HOMA-β,but positively with HOMA-IR.Compared with the 1st and 2nd quartiles of BMI,the fluctuation level of patients in the 3rd and 4th quartiles was lower.Multivariate logistic regression analysis showed that after adjustment of age,sex,cholesterol,triglyceride and hemoglobin,the risk of hyperglycemia fluctuation in the fourth quartile group was lower than that in the first quartile group(OR=0.594,95%CI:1.825~2.062).Conclusion The fluctuation of blood glucose in patients with higher BMI is lower than that in patients with lower BMI.
作者
陈俊秀
孙中帅
郑舟琴
王瑞风
杜宏
CHEN Jun-xiu;SUN Zhong-shuai;ZHENG Zhou-qin;WANG Rui-feng;DU Hong(Department of Endocrinology,Jinling Hospital,Nanjing University School of Medicine/General Hospital of Eastern Theater Command,PLA,Nanjing 210002,Jiangsu,China)
出处
《医学研究生学报》
CAS
北大核心
2020年第8期835-838,共4页
Journal of Medical Postgraduates
基金
江苏省自然科学基金(BK20161384)。
关键词
血糖波动
体重指数
2型糖尿病
glucose fluctuation
body mass index
type 2 diabetes
