超声下胰岛素注射皮下脂肪增生深径对糖尿病患者血糖控制的影响  

Impact of the depth of lipohypertrophy assessed by ultrasound on glycemic control in diabetic patients

作　　者：施云[1] 于健 王洪[1] 朱敏[1] 言丹[1] 沈敏 黄云 杭菁[2] 何畏[1] 徐晶晶[1] 杨涛[1] Shi Yun;Yu Jian;Wang Hong;Zhu Min;Yan Dan;Shen Min;Huang Yun;Hang Jing;He Wei;Xu Jingjing;Yang Tao(Department of Endocrinology and Metabolism,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China;Department of ultrasound,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学第一附属医院内分泌科,210029 [2]南京医科大学第一附属医院超声诊断科,210029

出　　处：《中华内分泌代谢杂志》2021年第11期1001-1003,共3页Chinese Journal of Endocrinology and Metabolism

基　　金：江苏省医学创新团队项目(CXTDA2017019)。

摘　　要：为评估超声下胰岛素注射皮下脂肪增生(lipohypertrophy)对糖尿病患者血糖控制的影响,选取2017年7月至2020年7月在南京医科大学第一附属医院内分泌科就诊的498例符合标准的接受胰岛素注射治疗的糖尿病患者为研究对象,收集临床资料,超声筛查皮下脂肪增生情况。85.1%(424/498)患者存在不同程度的皮下脂肪增生,皮下脂肪增生平均深径为(5.62±2.49)mm。与HbA1C≤7%组相比,HbA1C>7%组的患者皮下脂肪增生深径>5 mm比例增高(69.7%对81.3%,P<0.05)。二元logistics回归模型分析在校正了年龄、病程、糖尿病类型、治疗方案后,皮下脂肪增生深径>5 mm组HbA1C仍显著高于深径≤5 mm,提示皮下脂肪增生深径可能是HbA1C不达标的独立危险因素(OR=1.716,95%CI 1.104~2.668,P<0.05)。胰岛素注射皮下脂肪增生的形成是HbA1C达标的相关因素,但仍需前瞻性研究进一步证实其对血糖控制的影响。To evaluate the impact of the depth of lipohypertrophy on glycemic control in diabetic patients,498 diabetic patients were recruited from July 2017 to July 2020 in the First Affiliated Hospital of Nanjing Medical University.Their demographic and clinical data were collected.Lipohypertrophy was assessed with ultrasound.85.1%(424/498)of patients had lipohypertrophy.The average depth of lipohypertrophy was(5.62±2.49)mm.Compared with HbA_(1C)≤7%,patients with HbA_(1C)>7%had significantly higher proportion of lipohypertrophy with depth>5 mm(69.7%vs 81.3%,P<0.05).After adjusting potential confounders,the level of HbA_(1C)in patients with the depth of lipohypertrophy>5 mm was still significantly higher than those with the depth of lipohypertrophy≤5 mm(OR=1.716,95%CI 1.104-2.668,P<0.05).The depth of lipohypertrophy may be an independent risk factor for suboptimal HbA_(1C).However,prospective studies are still needed to confirm.

关 键 词：皮下脂肪增生 超声 HbA_(1C) 糖尿病 

分 类 号：R587.1[医药卫生—内分泌]