摘要
目的探究1型糖尿病(type 1 diabetes mellitus,T1DM)患者短期血糖波动与预估葡萄糖处置速率(estimated glucose disposal rate,eGDR)的相关性。方法本研究为回顾性研究,选取参加南京医科大学第一附属医院夏令营活动的T1DM患者作为研究对象。收集患者的临床资料,检测糖化血红蛋白A1c(glycated hemoglobin A1c,HbA1c)及1,5脱水葡萄糖醇(1,5-anhydroglucitol,1,5-AG),研究对象均佩戴持续血糖监测(continuous glucose monitoring,CGM)设备,记录血糖波动参数,基于CGM获得的血糖波动参数及1,5-AG作为短期血糖波动指标。通过匹兹堡公式计算预估葡萄糖处置速率(estimated glucose disposal rate,eGDR),用以评估患者的胰岛素抵抗(insulin resistance,IR)程度。根据eGDR中位数水平将研究对象分为高eGDR组和低eGDR组,采用t检验、χ^(2)检验、非参数检验对各组指标的差异进行比较,使用Spearman相关分析探究短期血糖波动指标与eGDR的相关性,采用岭回归模型评估eGDR的影响因素。结果本研究共纳入87例患者,低eGDR组(eGDR<11.07 mg·kg^(-1)·min^(-1))患者43例,高eGDR组(eGDR≥11.07 mg·kg^(-1)·min^(-1))44例。基于CGM所得的短期血糖参数高于目标范围内时间(time above range,TAR)、2级TAR、平均血糖(mean glucose,MG)、标准差(standard deviation,SD)与eGDR呈负相关(r=-0.646、-0.552、-0.659、-0.461,均P<0.05),TIR、1,5-AG与eGDR呈正相关(r=-0.646、-0.552、-0.211、-0.659、-0.461、0.551和0.417,均P<0.05)。岭回归分析结果显示,1,5-AG、TIR、TAR、2级TAR、MG是T1DM患者eGDR水平的显著影响因素(t值分别为2.386、3.652、4.367、2.882和2.507,均P<0.05)。结论T1DM患者短期血糖波动指标与eGDR具有显著相关性。通过监测短期血糖波动判断T1DM患者IR具有一定临床价值。
ObjectiveTo explore the relationship between metrics of short-term glycemic variability and estimated glucose disposal rate(eGDR)in patients with type 1 diabetes mellitus(T1DM).MethodsT1DM patients who participated in the summer camp activities at the First Affiliated Hospital of Nanjing Medical University were selected.Clinical information were recorded.Laboratory examinations including glycated hemoglobin A1c(HbA1c)and 1,5-anhydroglucitol(1,5-AG)were measured.All the participants wore continuous glucose monitoring(CGM)equipment,and the glycemic metrics derived from CGM were recorded.IR was measured as estimated glucose disposal rate(eGDR)by the Pittsburgh equation.Patients were divided into two groups based on the median level of eGDR.t-test,chi-square test and non-parametric test were applied to compare the differences of the parameters between the groups.Spearman correlation analysis was applied to explore the correlation between short-term glycemic variability metrics and eGDR.A ridge regression model was applied to assess the influencing factors of eGDR.ResultsA total of 87 patients with T1DM were included,43 patients in the low-eGDR group(eGDR<11.07 mg·kg^(-1)·min^(-1))and 44 patients in the high-eGDR group(eGDR≥11.07 mg·kg^(-1)·min^(-1)).The short-term glycemic variability metrics including time above range(TAR),TAR of level 2,mean glucose(MG),and standard deviation(SD)were negatively correlated with eGDR,TIR(r=-0.646、-0.552、-0.659、-0.461,all P<0.05),and 1,5-AG were positively correlated with eGDR(r=-0.646,-0.552,-0.211,-0.659,-0.461,0.551 and 0.417,respectively,all P<0.05).Ridge regression analysis showed that TIR,TAR,TAR of level 2,MG,and 1,5-AG are influencing factors of eGDR in T1DM patients(t=2.386,3.652,4.367,2.882 and 2.507,respectively,all P<0.05).ConclusionShort-term glycemic variability metrics are significantly associated with eGDR in T1DM patients.Monitoring of short-term glucose variability has profound clinical significance in evaluating IR in patients with T1DM.
作者
黄玫
戴刘宴
邵瀛
屈馨怡
张梅
Huang Mei;Dai Liuyan;Shao Ying;Qu Xinyi;Zhang Mei(Department of Endocrinology,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)
出处
《国际内分泌代谢杂志》
2024年第5期294-298,共5页
International Journal of Endocrinology and Metabolism
基金
国家自然科学基金项目(82370828)。
关键词
1型糖尿病
胰岛素抵抗
短期血糖波动
预估葡萄糖处置速率
Type 1 diabetes mellitus
Insulin resistance
Short-term glycemic variability
Estimated glucose disposal rate
