新诊断2型糖尿病患者日内平均血糖波动幅度影响因素分析  

Identification of the factors influencing 24 h mean amplitude of glycemic excursion in newly diagnosed type 2 diabetes mellitus

作　　者：孔小岑[1] 孙进[1] 李婷[1] 马建华[1] 刘炳丽[1] 

机构地区：[1]南京医科大学附属南京医院内分泌科,江苏南京210012

出　　处：《南京医科大学学报（自然科学版）》2016年第7期835-839,共5页Journal of Nanjing Medical University(Natural Sciences)

基　　金：国家自然科学基金青年基金(81400840)

摘　　要：目的 :探讨新诊断2型糖尿病患者日内平均血糖波动幅度(24 h mean amplitude of glycemic excursions,MAGE)影响因素。方法:110例未经治疗的新诊断2型糖尿病患者行连续3 d动态血糖监测(continuous glucose monitoring system,CGMS),计算MAGE;收集患者基线资料,并检测糖化血红蛋白(hemoglobin A1c,Hb A1c)、空腹血糖(fasting blood glucose,FBG)及口服糖耐量试验(OGTT)餐后2 h血糖(postprandial 2 h blood glucose,PBG)、胰岛素、C肽、血脂、肾功能、肝功能。结果:Hb A1c是新诊断2型糖尿病MAGE的独立影响因素(P<0.05),Hb A1c<9.9%患者的MAGE显著低于Hb A1c≥9.9%患者(5.97 mmol/L vs.7.43 mmol/L,P<0.05)。其中当Hb A1c<8.5%时,Hb A1c主要受PBG影响,但当Hb A1c≥9.2%时,则FBG是新诊断2型糖尿病患者Hb A1c的独立影响因素(P<0.001)。FBG<10.84 mmol/L患者的Hb A1c显著低于FBG≥10.84 mmol/L患者(9.10%vs.10.87%,P<0.001)。结论:Hb A1c是新诊断2型糖尿病患者MAGE的独立影响因素,其中FBG与Hb A1c密切相关。Objective：To identify the factors influencing 24 h mean amplitude of glycemic excursion （MAGE） in patients newly diagnosed with type 2 diabetes. Methods：We analyzed the clinical data of 110 patients with type 2 diabetes without treatment. The 24 h MAGE was calculated using 3 d continuous glucose monitoring system （CGMS）. Baseline data of patients were collected, and serum hemoglobin Alc （HbAlc）, fasting blood glucose （FBG） and postprandial 2 h blood glucose （PBG）, insulin and C peptide levels, blood lipid profiles, hepatic and renal functions were measured before treatment. Results： HbAlc was an independent index for 24 h MAGE in newly diagnosed type 2 diabetes mellitus patients（P 〈 0.05）. MAGE in patients with HbAlc 〈 9.9% was lower than that with HbAlc≥9.9%（5.97 mmol/L vs. 7.43 mmol/L, P 〈 0.05）. HbAlc in patients with HbAlc 〈 8.5% was effected mainly by PBG, while FBG was an independent factor influencing HbAlc in newly diagnosed type 2 diabetes mellitus patients with HbAlc ≥9.2%（P 〈 0.001）. HbAlc in patients with FBG 〈 10.84 mmol/L was lower than that with FBG≥10.84 mmol/L（9,10% vs. 10.87%, P 〈 0.001 ）. Conclusion： HbAlc is an independent factor of MAGE and closely related to FBG in patients newly diagnosed with type 2 diabetes mellitus.

关 键 词：新诊断2型糖尿病 日内平均血糖波动幅度 糖化血红蛋白A1C 空腹血糖 

分 类 号：R587.1[医药卫生—内分泌]