用动态血糖监测观察血糖波动对胱抑素C水平影响的研究  

Investigate the influence of dynamic glucose excursionon serum cystatin C by dynamic glucose monitoring

作　　者：曹惠红 陈海冰[3] 李昀昊[4] 

机构地区：[1]苏州大学医学部,215123 [2]上海中医药大学附属岳阳中西医结合医院闵行分院内分泌科 [3]上海交通大学附属第六人民医院内分泌代谢科 [4]上海中医药大学附属岳阳中西医结合医院内分泌科

出　　处：《中国糖尿病杂志》2018年第3期211-216,共6页Chinese Journal of Diabetes

基　　金：上海市闵行区自然科学研究课题(2016MHZ58)

摘　　要：目的应用动态血糖监测系统观察T2DM患者血糖波动对血清胱抑素C(Cys-C)的影响。方法选取T2DM住院患者164例,行连续72h动态血糖监测,计算血糖波动参数,包括血糖标准差(SD)、平均血糖水平(MBG)。根据监测结果分为血糖高漂移组和血糖低漂移组。同时检测Cys-C水平等其他生化指标,分析两组SD和Cys-C的相关性。结果血糖高漂移组和血糖低漂移组年龄、BUN、SUA、eGFR、Cys-C比较,差异有统计学意义(P<0.05)。血糖高漂移组Cys-C均值及Cys-C升高的百分率均高于血糖低漂移组。164例患者SD与Cys-C呈正相关(r=0.344,P<0.01),血糖高漂移组与血糖低漂移组中SD与Cys-C均呈正相关(r=0.604、0.331,P<0.01)。血糖高漂移组糖尿病周围血管病变(PAD)、糖尿病周围神经病变(DPN)、DR、糖尿病肾脏疾病(DKD)的发生率均高于血糖低漂移组。多元线性逐步回归分析显示,WC、糖化白蛋白(GA)、FPG、FIns、SUA、eGFR、SD均为Cys-C的独立危险因素,其中SD的贡献度最大(β′=0.112,SE=0.025,P=0.000)。结论 T2DM患者动态血糖波动与Cys-C呈正相关,血糖波动越大,Cys-C升高越明显。Objective Using dynamic glucose monitoring system to investigate the influence of dynamic glucose excursion onthe serum cystatin C（Cys-C）in patients with type 2 diabetes mellitus（T2DM）. Methods A total of 164 hospitalized patients with T2DM were selected in this study.All the patients underwent continuous 72 hours dynamic glucose monitoring.The parameters of glucose excursion were calculated,including blood glucose standard deviation（SD）,and average blood glucose level（MBG）.According to the monitoring results,the patients were divided into two groups：high blood glucose excursion groupand low blood glucose excursion group.Cys-C level and other biochemical parameters were detected.Then the correlation of SD and Cys-C was analyzedin the two groups. Results There were significant difference in age,urea nitrogen（BUN）,serum uric acid（SUA）,glomerular filtration rate（eGFR）,and Cys-C levels between the two groups（P〈0.05）.The mean value of Cys-C and the percentage of high Cys-C level were higher in high blood glucose excursion group than in low blood glucose excursion group.There was a positive correlation between SD and Cys-C（r=0.344,P〈0.01）in the whole group as well as in high blood glucose excursion group and low blood glucose excursion group（r=0.604,0.331,P〈0.01）.The incidence of diabetic peripheral arterial disease（PAD）,diabetic peripheral neuropathy（DPN）,diabetic retinopathy（DR）,DKD were higher in high blood glucose excursion groupthan in the low blood glucose excursion group.Multivariate stepwise regression analysis showed that WC,GA,FPG,FIns,SUA,eGFR,and SD were in dependent risk factors for Cys-C,and among them,SD had the greatest contribution（β=0.112,SE=0.025,P=0.000）. Conclusion The dynamic glucose excursion is positively correlated with Cys-C in patients with T2DM.The greater the blood glucose excursion,the higher the Cys-C level.

关 键 词：糖尿病 2型 动态血糖监测 血糖波动 胱抑素C 

分 类 号：R587.1[医药卫生—内分泌]