摘要
目的探讨2型糖尿病(T2DM)患者并发感染与葡萄糖目标范围内时间百分比(TIR)的相关性。方法选取重庆医科大学附属第三医院内分泌疾病中心2019年9月—2021年1月收治的246例16岁以上T2DM患者,根据是否并发感染分为感染组(n=89)与非感染组(n=157),比较2组患者基线数据和血糖波动有关参数,采用二元Logistic回归分析影响T2DM患者TIR达标的因素。结果感染组患者女性比例及白细胞计数(WBC)、中性粒细胞百分比(N)、糖化血红蛋白(Hb A1c)、糖化白蛋白(GA)、空腹血糖(FPG)水平及单用外源性胰岛素比例均高于非感染组,有吸烟史、有饮酒史、单用口服降糖药物比例及预估肾小球滤过率(e GFR)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDLC)水平均低于非感染组,差异均有统计学意义(P<0.05)。感染组患者TIR水平、TIR达标率均低于非感染组,高血糖时间范围(TAR)、平均血糖值(MBG)、预估e Hb Alc(e Hb A1c)、血糖变异系数(CV)、血糖标准差(SDBG)、日间血糖平均绝对差(MODD)水平均高于非感染组,差异均有统计学意义(P<0.05)。TIR达标患者WBC、N、TAR、MBG、e Hb A1c、CV、SDBG、平均血糖波动幅度(MAGE)、MODD、Hb A1c、GA、FPG水平及感染发生率、单用外源性胰岛素比例、口服降糖药物与外源性胰岛素均使用比例均低于TIR未达标组,超质量或肥胖、Hb A1c<7%比例及TIR、体质量指数(BMI)、低血糖时间范围(TBR)、血清C肽、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)水平均高于TIR未达标组,差异均有统计学意义(P<0.05)。二元Logistic回归分析结果显示,WBC水平偏高、口服降糖药物与外源性胰岛素均使用为影响T2DM患者TIR达标的危险因素(P<0.05)。结论TIR与T2DM患者并发感染相关,是一种有价值的临床血糖控制评价指标。针对住院T2DM患者应积极控制感染,从而控制危险因素,优化TIR达标。
Objective To investigate the correlation between concurrent infection and glucose time in range(TIR)in patients with type 2 diabetes mellitus(T2DM).Methods Two hundred and forty-six T2DM patients over 16 admitted to the Center for Endocrine Disease of the Third Affiliated Hospital of Chongqing Medical University from September 2019 to January 2021 were selected as study participants.They were assigned to an infection group(n=89)and a non-infection group(n=157)according to the presence or absence of concurrent infection.Baseline data and blood glucose fluctuation-related parameters were compared between the two groups.The factors affecting TIR compliance in T2DM patients were analyzed using Binary logistic regression.Results The proportion of female patients,white blood cell count(WBC),neutrophil percentage(N),glycosylated hemoglobin(HbA1c),glycosylated albumin(GA),and fasting plasma glucose(FPG),single-use of exogenous insulin in the infection group were significantly higher than those in the non-infection group.The smoking history,drinking history,single-use of oral hypoglycemic drugs and estimated glomerular filtration rate(eGFR),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C)and low-density lipoprotein cholesterol(LDL-C)levels were significantly lower than those in the non-infection group(P<0.05).The TIR level and TIR compliance rate in the infection group were significantly lower than those in the non-infection group;the time above range(TAR),mean blood glucose(MBG),estimated HbA1c(eHbA1c),coefficient of variation(CV)of blood glucose,the standard deviation of blood glucose(SDBG),and mean of daily differences of blood glucose(MODD)levels were significantly higher than those in the non-infection group(P<0.05).WBC,N,TAR,MBG,eHbA1c,CV,SDBG,mean amplitude of glucose excursion(MAGE),MODD,HbA1c,GA,FPG levels and incidence of infection,the proportion of single-use exogenous insulin and oral hypoglycemic agents used with exogenous insulin were lower in patients reaching TIR targets than in those who
作者
秦思
倪银星
钟健
Qin Si;Ni Yinxing;Zhong Jian(Center for Endocrine Disease,the Third Affiliated Hospital of Chongqing Medical University,Chongqing 401120,China)
出处
《保健医学研究与实践》
2023年第1期6-12,共7页
Health Medicine Research and Practice
基金
国家自然科学基金资助项目(81670382)
重庆市体育局科研项目(B201710)
重庆医科大学附属第三医院科研孵化项目(KY20075)。
关键词
2型糖尿病
目标范围内时间百分比
感染
Type 2 diabetes mellitus
Percentage of time in range
Infection
