动态血糖监测在单纯性肥胖患者中的应用  

Application of dynamic glucose monitoring in patients with simple obesity

作　　者：曹怡[1] 邱春娟[1] 焦秀敏[1] 陈彬[1] 吕肖锋[1] 

机构地区：[1]北京军区总医院内分泌科,北京100700

出　　处：《中国卫生检验杂志》2015年第18期3119-3122,共4页Chinese Journal of Health Laboratory Technology

摘　　要：目的通过动态血糖监测系统分析单纯性肥胖患者的血糖变化特点。方法分别对21例一级亲属患有糖尿病的单纯性肥胖患者及正常非肥胖者进行OGTT、CGM、Hb A1c检测,分析并比较2组OGTT结果、Hb A1c水平及动态血糖监测各项参数,包括MBG、SDBG、MAGE、LAGE等。结果 21例肥胖患者的平均Hb A1c水平与正常体重者相比较,差异无统计学意义(P>0.05);OGTT结果显示,肥胖患者中有5例(23.8%)存在空腹血糖受损(IFG)(FBG≥5.6 mmol/L且<7.0 mmol/L),5例(23.8%)存在糖耐量减低(IGT)(2 h BG≥7.8 mmol/L且<11.1 mmol/L),没有确诊为糖尿病的患者。动态血糖监测(CGM)结果显示,肥胖组MBG与正常组相比差异无统计学意义(P>0.05),肥胖组SDBG、MAGE与LAGE均较正常组显著升高(P<0.01)。CGMS检测到7例(33.3%)血糖最大值≥11.1 mmol/L,5例(23.8%)餐后2 h血糖≥11.1 mmol/L,3例(14.3%)出现了低血糖(<3.0 mmol/L)。结论动态血糖监测系统(CGMS)能够较传统方法(如OGTT和Hb A1c)检测到更多的血糖异常,尤其对于有糖尿病家族史的肥胖患者,可通过CGMS尽早发现异常的血糖及血糖波动情况,并及时给予干预措施,减少糖尿病及其并发症的发生。Objective Analysis of the characteristics of blood glucose in simple obesity patients by dynamic glucose monitoring system. Methods Data of oral glucose tolerance test （OGTT）, continuous glucose monitoring （CGM） and hemoglobin A （HbAlc） test in 21 obese first - degree relatives of simple obese patients with diabetes and normal non obese persons were detected, and the two groups of OGrIT results, HbA1 c level and dynamic blood glucose monitoring parameters were analyzed and compared, including mean blood glucose（MBG） , the standard deviation of blood glucose（SDBG） , the mean amplitude of glucose excursion（MAGE） and the largest amplitude of glucose excursion （LAGE）. Results There was no significant difference between the mean HbAlc levels of 21 patients with obesity and normal weight（P 〉 0.05 ） ; OGTTresults showed that in obese patients, 5 cases （ 23.8% ） have impaired fasting glucose （IFG） （ FBG ≥ 5.6 mmol/L and 〈 7.0 mmol/L） and 5 cases （23.8%） have impaired glucose tolerance（IGT） （2 h BG≥7.8 mmol/L and 〈 11.1 mmol/L） without diagnosed diabetes. Continuous glucose monitoring（CGM） showed that there was no significant difference between the MBG and the normal group （P 〉 0. 05）. The SDBG, MAGE and LAGE in the obese group were significantly higher than those in the normal group（P 〈 0.01 ）. There were 7 cases （33.3 % ） maximal blood glucose （BG） ≥ 11.1 mmol/L, 5 cases （ 23.8% ） 2 h postprandial BG≥11.1 mmol/L, and 3 cases（ 14.3% ） appeared hypoglycemia（ 〈 3.0 mmol/L）. Conclusion CGMS can detect more abnormal glycemic profiles than traditional methods（ such as OGTF and HbAlc）, especially for obese patients with diabetes family history. Early detection of abnormal blood glucose and blood glucose fluctuation can be found by CGMS monitoring, and timely intervention measures can be made to reduce the occurrence of diabetes and its complications.

关 键 词：动态血糖监测 肥胖 血糖波动 

分 类 号：R589.2[医药卫生—内分泌]