女性绝经状态对2型糖尿病患者血糖控制的影响  

Effect of menopausal status on blood glucose control for patients with Type 2 Diabetes

作　　者：孙小燕[1] 杨霞[1] 朱若昕 张宝丽[1] 张学红[1] 

机构地区：[1]兰州大学第一医院生殖医学专科医院,甘肃兰州730000

出　　处：《发育医学电子杂志》2017年第2期73-77,共5页Journal of Developmental Medicine (Electronic Version)

摘　　要：目的分析2型糖尿病患者在围绝经期、绝经早期两种绝经状态下血糖控制情况的差异,探讨绝经状态对血糖控制的影响。方法 2013年6月至2016年5月,在兰州大学第一医院住院的2型糖尿病女性患者中,纳入年龄45~64岁者,共纳入802例研究对象,根据患者年龄分组,45~54岁为围绝经期组,共362例;55~64岁为绝经早期组,共440例。采用回顾性观察性研究的方法,比较两组患者的基本情况、性激素水平、以及血糖控制的相关指标。采用独立样本t检验、χ~2检验进行统计分析。结果围绝经期组与绝经早期组的糖尿病病程分别为(6.2±5.0)与(7.6±5.5)年,合并高血压的比例分别为40.9%与54.3%,绝经早期组较高(P值均﹤0.05)。围绝经期组及绝经早期组分别有37例及28例患者进行了性激素测定,雌二醇水平分别为(99.5±39.0)与(41.7±27.2)pmol/L,围绝经期组较高;卵泡刺激素水平分别为(30.5±22.3)与(45.4±24.8)U/L,黄体生成素水平分别为(17.7±13.1)与(29.8±11.2)U/L,绝经早期组较高(P值均﹤0.01)。围绝经期组空腹血糖高于绝经早期组[(10.0±3.8)与(8.9±3.6)mmol/L,P﹤0.01];围绝经期组与绝经早期组的胰岛素促泌剂使用率分别为30.4%与22.5%,二甲双胍使用率分别为83.7%与77.5%,围绝经期组较高(P值均﹤0.05);α-糖苷酶抑制剂使用率分别为48.9%与59.1%,绝经早期组较高(P﹤0.01)。两组的糖化血红蛋白、胰岛素使用率、住院天数、住院费用比较,差异均无统计学差异(P值均>0.05)。结论与绝经早期相比,围绝经期2型糖尿病女性空腹血糖水平较高,血糖更难控制。Objective To study the difference in blood glucose control for patients with Type 2 Diabetes （T2D） between perimenopausal stage and early stage of menopause, and to explore the effect of menopausal status on blood glucose control. Methods From June 2013 to May 2016, in The First Hospital of Lanzhou University, 802 hospitalized women aged 45-64 years old with T2D were included. According to the age, they were divided into the perimenopausal group （45-54 years old, 362 cases） and the early stage of menopause group （55-64 years old, 440 cases）. Retrospective observational study method was used. The general conditions, level of sex hormone and indications of blood glucose control were compared between the two groups. Independent sample t-test and ;（2 test were used for statistical analysis. Results In the perimenopausal group and the early stage of menopause group, course of T2D was （6.2 ± 5.0） vs （7.6 ± 5.5） years and the proportion of hypertension was 40.9% vs 54.3%, which were higher in the early stage of menopause group （all P 〈 0.05）. 37 patients in the perimenopausal group and 28 patients in the early stage of menopause group detected the level of sex hormone. The estradiol level was （99.5 ± 39.0） vs （41.7 ± 27.2） pmol/L, which was higher in the perimenopausal group. The level of follicle-stimulating hormone was （30.5 ± 22.3） vs （45.4 ± 24.8） U/L, and the level of luteinizing hormone was （17.7 ± 13.1） vs （29.8 ± 11.2） U/L, which was higher in the early stage of menopause group （P 〈 0.01）. Fasting blood glucose of the perimenopausal group was higher than that of the early stage of menopause group [ （10.0 ± 3.8） vs （8.9 ± 3.6） mmol/L, P 〈 0.01 ] . The utilization rate of insulin secretion was 30.4% vs 22.5% and that of metformin was 83.7 % vs 77.5 % in perimenopausal group and early stage of menopause group respectively, which were both higher in the perimenopausal group （both P 〈 0.05）. The utilization rate of ±-glycosidase inhi

关 键 词：绝经 围绝经期 绝经早期 2型糖尿病 血糖控制 

分 类 号：R587.1[医药卫生—内分泌]