短病程老年糖尿病同型半胱氨酸水平与血糖波动系数的相关性  

Correlation between plasma homocysteine levels and blood glucose fluctuation coefficient in elderly patients with short-term diabetes mellitus

作　　者：李英[1] 梁新华[1] 安娜[1] 王敏哲[1] 

机构地区：[1]新疆医科大学第五附属医院内分泌科,乌鲁木齐市830011

出　　处：《实用医学杂志》2014年第3期402-405,共4页The Journal of Practical Medicine

摘　　要：目的：探讨短病程（病程在5年以内）老年2型糖尿病（T2DM）患者血浆同型半胱氨酸（Hey）水平与血糖波动系数的相关性。方法：选取87例病程在5年以内的老年T2DM住院患者，采用生化检测方法测血浆Hcy，并佩戴雷兰实时动态血糖监测系统（RT．CGMS），按照血糖波动系数（S）分为≤1．5组（sl组），1．5～2．0组（S2组）及〉2．0组（S3组），对3组的一般资料及多项生化指标进行观测和统计，对血糖波动相关危险因素进行Logistic回归分析。结果：平均血糖波动幅度（MAGE）、24h血糖水平标准差（SDBG）、24h最大血糖波动幅度（L．AGE）、餐后血糖值波动幅度的平均值（M．PPGE）均与血糖波动系数（S）密切相关（P〈0．01）。血浆Hcy水平s2组[（17．51-4-5．78）Ixmol／L]、s3组[（19．54-4-6．42）p,mol／L]与s1组[（7．98±2．56）p,mol／L]比较，差异有统计学意义（P〈0．05）；接受胰岛素治疗的比例：s2组、s3组与s1组比较，差异有统计学意义（P〈0．017）；甘油三酯指标：s3组、s2组s1组比较，差异也有统计学意义（P〈O．05）。多元Logistic回归分析显示，高同型半胱氨酸血症、年龄、接受胰岛素治疗为血糖波动的危险因素。结论：血糖波动系数可准确评估血糖波动程度．血浆Hey水平可作为老年T2DM患者血糖波动的预测指标。Objective To investigate the correlations between plasma homocysteine levels （Hcy） and blood glucose fluctuation coefficient in elderly patients with short-term （less than 5 years） type 2 diabetes mellitus （T2DM）. Methods Eighty seven elderly type 2 diabetic inpatients with a course of 5 years were eligibly recruited. Hcy was measured using biochemical detection. All of them underwent Guardian RT continuous glucose monitoring system （RT-CGMS）. According to blood sugar fluctuation coefficient （S）,the patients were divided into three group： S≤1.5 （S1 group）, 1.5 〈 S≤ 2.0 group （S2 group） and S 〉 2.0 group （S3 group）. The general data of the three groups and biochemical indicators were observed and analyzed. The risk factors associated with blood glucose fluctuations were analyzed by Logistic regression analysis. Results Average blood glucose fluctuation （MAGE）, standard deviation for 24 h blood glucose level （SDBG）, 24 h biggest blood glucose swings （L-AGE）, the average value of volatility postprandial blood sugar （M-PPGE） were closely related to blood sugar fluctuation coefficient （S） （P 〈 0.01）. The levels of plasma Hcy in S2 and S3 group were significantly higher than that in S1 group （P 〈 0,05）. The cases receiving insulin treatment in S2 and S3 group were significantly more than that in S1 group （P 〈 0.017）. The levels of triglyceride in S2 and S3 group were significantly higher than that in S1 group （P 〈 0.05）. Homoeysteine levels, age and insulin treatment were related independently and significantly with fluctuation by multivariate Logistic regression analysis. Conclusion Blood sugar fluctuation coefficient can be accurate for the assessment of blood sugar fluctuations and plasma homocysteine levels can be used as a predictor of blood sugar fluctuations in elderly patients with type 2 diabetes mellitus.

关 键 词：糖尿病 2型 老年 同型半胱氨酸 血糖波动系数 

分 类 号：R587.1[医药卫生—内分泌]