2型糖尿病肾功能损害与动态血糖及同型半胱氨酸的相关性研究  

The relationship between renal function and dynamic blood glucose fluctuationand homocysteine in patients with type 2 diabetes mellitus

作　　者：郑筱玮[1] 褚建平[1] 徐淼[1] 李佳霖[1] 卢杰[1] 王兴珍[1] 林仿[1] 励丽[1] 钮雁文[1] 毛洲宏[1] 吴凌云[1] 

机构地区：[1]宁波市第一医院,宁波315010

出　　处：《现代实用医学》2016年第9期1131-1133,共3页Modern Practical Medicine

基　　金：宁波市科学技术局社会发展攻关项目(201401C5010047)

摘　　要：目的探讨处于不同肾功能阶段的2型糖尿病(T2DM)的动态血糖及同型半胱氨酸(Hcy)变化。方法选取T2DM患者155例,按肾功能分期分为DN1组、DN2组及DN3组,比较3组的血糖波动系数及Hcy等相关指标。结果 DN1组和DN2组的Hcy水平均小于DN3组(均P<0.05),但DN1组和DN2组差异无统计学意义(P>0.05);肾小球滤过率(eGFR)与Hcy水平呈负相关(P<0.01)。DN1和DN2组间的平均血糖波动幅度(MAGE)、平均血糖(MBG)、HOMA-IR及HOMA-S差异均无统计学意义(均P>0.05),但DN1和DN2组的MAGE、MBG、HOMA-IR分别低于DN3组,HOMA-S高于DN3组(均P<0.05);e GFR与MAGE值呈负相关(P<0.01),与日间血糖平均绝对差(MODD)无相关性(P>0.05)。结论肾功能正常或肾损伤早期时的Hcy水平与动态血糖系数无明显差异,当肾功能损伤晚期时可以通过Hcy及MAGE估测肾功能损伤的情况。Objective To explore the dynamic blood glucose and homocysteine level in type 2 diabetes patients with different stages of renal function by using continuous glucosemonitoring system （CGMs）. Methods One hundred and fifty-five patients with type 2 diabetes mellitus were divided into three groups （DN1, DN2 and DN3） according to renal functions. Glycemic variabilityparameters and homocysteine value of three groups were compared. Results Homocysteine level was significantly higher in group DN3 than other two groups （all P 〈 0.05）, but there was no significance between group DN1 and group DN2 （P 〉 0.05）. Mean amplitude of dycemic excursion （MAGE）, mean blood glucose （MBG）, homeostasis model assessment of insulin resistance （HOMA-IR） and insulin sensitivity （HOMA-S） were not significantly different between group DN1 and group DN2. MAGE, MBG, HOMA-IR of groupDN1 and group DN2 were significantly lower than those of group DN3 （ all P 〈 0.05）, but HOMA-S was higher （P 〈 0.05）. The eGFR had negative relationship with MAGE （P 〈 0.05）, but it was not related with absolute means of daily differences （MODD）. Conclusions There was no significant difference between Hey level and dynamic blood glucose level at the early stage of renal injury or normal renal function, and renal function impairment could be estimated by Hey and MAGE at the late stage of renal function injury.

关 键 词：糖尿病肾病 同型半胱氨酸 动态血糖监测系统 

分 类 号：R587.1[医药卫生—内分泌]