摘要
目的 持续葡萄糖监测系统(CGM)分析成人T1DM患者血糖波动的影响因素。方法选取2019年9月至2021年6月于中南大学湘雅二医院T1DM综合管理门诊就诊的T1DM患者220例,进行5~7 d回顾式CGM监测收集血糖数据。Spearman相关分析CGM血糖波动参数与其他指标的相关性。根据FC-P与混合餐耐量试验刺激后2 hC-P水平分组,比较两组血糖波动指标。结果Spearman相关分析显示,高于目标范围内时间(TAR)、平均血糖(MBG)、血糖标准差(SD)、平均血糖波动幅度(MAGE)、日间血糖平均绝对差(MODD)、血糖变异系数(CV)与年龄、单位体重胰岛素日剂量、HbA1c、FPG、2 hPG呈正相关(P<0.05),目标范围内时间(TIR)与年龄、单位体重胰岛素日剂量、HbA1c、FPG、2 hPG呈负相关(P<0.01)。低于目标范围内时间、SD、MAGE、MODD、CV与DM病程呈正相关(P<0.05),TIR与DM病程呈负相关(P<0.01)。TIR与FC-P、2 hC-P呈正相关(P<0.01),TAR、MBG、SD、MAGE、MODD、CV与FC-P、2 hC-P呈负相关(P<0.01)。与FC-P≤16.5 pmol/L组比较,FC-P>16.5 pmol/L组年龄、DM病程、每日胰岛素总剂量、单位体重胰岛素日剂量、TAR、MBG、SD、MAGE、MODD、CV降低(P<0.05),TIR升高(P<0.05)。与低反应组比较,高反应组年龄、DM病程、HbA1c和FPG降低(P<0.05),TIR升高,TAR、MBG、SD、MAGE、MODD、CV均低于低反应组(P<0.05)。结论 除空腹及餐后C-P水平较高的成人T1DM患者TIR较高、血糖波动较小外,年龄较小、DM病程较短、单位体重胰岛素日剂量较小和HbA1c水平较低患者血糖波动也较小。
Objective To explore the influencing factors associated with glucose variability in adults with type 2 diabetes mellitus(T1DM)by continuous glucose monitoring(CGM).MethodsA total of 220 adults with T1DM from the T1DM Clinic of the Second Xiangya Hospital,Central South University were recruited in this study. All the patients wore retrospective CGM for 5 to 7 days to collect glucose data.Spearman correlation analysis was performed to analyze the correlation between CGM-derived glucose variability indices and clinical factors. Patients were divided into two groups according to fasting C-peptide(FC-P)and 2-h C-peptide(2 hC-P)levels after mixed meal tolerance stimulation test(MMTT). Glucose variability parameters were compared between the two groups.ResultsSpearman correlation analysis showed that time above target rang(eTAR),average blood glucose(MBG),standard deviation(SD),average blood glucose fluctuation range(MAGE),mean absolute difference(MODD)and blood glucose variation coefficient(CV)in the target range were positively correlated with age,daily dose of insulin per unit weight,HbA1c,FPG and 2 hPG(P<0. 05). time below target range,SD,MAGE,MODD,CV are positively correlated with the course of DM(P<0. 05),while TIR is negatively correlated with the course of DM(P<0. 01). There is a positive correlation with TIR FC-P and 2 hC-P(P<0. 01),while TAR,MBG,SD,MAGE,MODD and CV are negatively correlated with FC-P and 2 hC-P(P<0. 01). Compared with FC-P≤16. 5 pmol/L group,age,DM duration,total daily insulin dose,daily insulin dose per unit weight,TAR,MBG,SD,MAGE,MODD and CV decreased,while TIR increased in FC-P>16. 5 pmol/L group(P<0. 05). Compared with the low response group,age,DM duration,HbA1c and FPG decreased,TIR increased in the high response group(P<0. 05). TAR,MBG,SD,MAGE,MODD and CV were significantly lower in high response group than in low response group(P<0. 05).Conclusion Higher fasting and postprandial C-peptide levels were associated with higher TIR and smaller glucose variability in adults with T1DM. In a
作者
张力引
郭柯宇
吴洁如
许雅玲
姜晓芳
范黎
李霞
杨琳
ZHANG Liyin;GUO Keyu;WU Jienu(Department of Melabolism and Endocrinology,The Second Xiangyu Hospital of Central South Uniuersity,Changsha 410011,China)
出处
《中国糖尿病杂志》
CAS
CSCD
北大核心
2022年第6期436-442,共7页
Chinese Journal of Diabetes
基金
国家重点研发计划项目课题(2018YFC2001005)。
关键词
糖尿病
1型
血糖波动
C肽
持续葡萄糖监测系统
Diabetes mellitus,type 1
Glycemic variability
C-peptide
Continuous glucose monitoring
