早期糖尿病肾病患者血糖波动与脂联素的相关性研究  

Correlation of blood glucose fluctuation with adiponectin in early diabetic nephropathy

作　　者：舒毅[1] 陈幼萍[1] 刘大川[1] 曾春平[1] 梁蕴谊[1] 刘帅[1] 叶静文[1] 

机构地区：[1]南方医科大学附属广东南海人民医院内分泌科,广东佛山528200

出　　处：《临床医学》2015年第4期3-5,共3页Clinical Medicine

基　　金：佛山市医学类科技攻关项目(201208129)

摘　　要：目的探讨血糖波动与早期糖尿病肾病脂联素的相关性。方法 30例应用诺和灵30R治疗的早期2型糖尿病肾病患者[糖化血红蛋白(Hb A1c)>7.5%]改用诺和锐30治疗12周,治疗前后进行连续72 h动态血糖监测,同时观测体质量指数(BMI)、空腹血糖(FBG)及餐后2 h血糖(2 h PG)、Hb A1c、总胆固醇(TC)、三酰甘油(TG)、脂联素(APN)、高敏C-反应蛋白(hs-CRP)、尿微量白蛋白(MA)及尿肌酐(UCr)等指标变化。结果经诺和锐30治疗后,BMI、FBG、TC和TG与治疗前比较无明显变化,Hb A1c较治疗前有所下降,但差异未见统计学意义(P>0.05);2 h PG、hs-CRP、尿微量白蛋白/肌酐比值(ACR)均明显下降(P均<0.05),APN明显升高(P<0.05);24 h平均血糖水平(24 h MBG)治疗前后比较差异未见统计学意义;日间平均血糖波动幅度(MAGE)、日间血糖平均绝对差(MODD)及餐后血糖波动幅度(PPGE)治疗后与治疗前比较均有不同程度的下降,差异有统计学意义(P均<0.05)。相关性分析显示,治疗后APN与2 h PG、Hb A1c、hs-CRP、ACR、MAGE及PPGE呈负相关。结论诺和锐30治疗能减轻血糖波动,可能通过增加糖尿病肾病APN水平对肾脏起保护作用。Objective To investigate the correlation of blood glucose fluctuation with adiponectin in type 2 diabetic patients with incipient nephropathy. Methods Thirty type 2 diabetic patients with incipient nephropathy（ Hb A1 c 7. 5%） previously treated with Premixed human insulin 30 /70（ BHI 30） were switched to BIAsp 30 for 12-week treatment. Data from continuous glucose monitor for 72 hours,body mass index（ BMI）,fasting blood glucose（ FBG）,2-hour postprandial blood glucose（ 2 h PG）,Hb A1 c,total cholesterol（ TC）,triglyceride（ TG）,adiponectin（ APN）,high sensitive C-reactive protein（ hs-CRP）,urine microalbumin（ MA）,and urine creatinine（ UCr） were measured before and after 12-week treatment,respectively.Results After 12-week treatment,there was no difference in BMI,FBG,Hb A1 c,TC,TG and 24 h-mean blood glucose（ 24 h MBG）（ P〉0. 05）. The 2 h PG,hs-CRP and urinary albumin-to-creatinine ratio（ ACR） decreased significantly,while the concentration of APN increased significantly after treatment（ P〈0. 05）. There were significantly lower levels of mean amplitude of glycemic excursions（ MAGE）,absolute means of daily differences（ MODD） and postprandial glucose excursion（ PPGE） after treatment than those before treatment. In correlation analysis,APN showed negative correlation with 2 h PG,Hb A1 c,hs-CRP,ACR,MAGE and PPGE. Conclusion BIAsp 30 can reduce blood glucose fluctuation,which may play a protective role by increasing APN in early diabetic nephropathy.

关 键 词：血糖波动 动态血糖监测 糖尿病肾病 2型糖尿病 脂联素 胰岛素 

分 类 号：R587.2[医药卫生—内分泌]