持续血糖监测评估的目标范围内时间与老年2型糖尿病患者蛋白尿的相关性研究  

A study of relationship between time in target range assessed by continuous glucose monitoring and proteinuria in elderly patients with type 2 diabetes mellitus

作　　者：宋静[1] 卢叶[1] 王文婕 李丽 杜炜[1] 万静[1] Song Jing;Lu Ye;Wang Wenjie;Li Li;Du Wei;Wan Jing(Department of Endocrinology,Eighth People's Hospital of Shanghai City,Shanghai,200235,P.R.China)

机构地区：[1]上海市第八人民医院内分泌科,上海200235

出　　处：《老年医学与保健》2024年第4期1078-1083,共6页Geriatrics & Health Care

基　　金：徐汇区医学科研课题(SHXH201329)。

摘　　要：目的探讨老年2型糖尿病(T2DM)患者目标范围内时间(TIR)与糖尿病蛋白尿的关系。方法回顾性分析2016年10月—2020年8月上海市第八人民医院住院的176例老年T2DM患者临床资料。按患者的尿微量蛋白/尿肌酐比值分为正常蛋白尿组(n=99)、微量蛋白尿组(n=51)和大量蛋白尿组(n=26),比较3组一般资料及持续血糖监测指标。Spearman相关系数分析及多元序回归分析TIR四分位数与糖尿病蛋白尿严重程度的相关性。结果3组间性别、T2DM病程、高血压构成比、吸烟史、胰岛素使用、血管紧张素转换酶抑制剂及血管紧张素II受体阻滞剂使用、他汀类药物使用、收缩压、总胆固醇、低密度脂蛋白胆固醇、估算肾小球滤过率、平均血糖波动幅度、TIR及糖尿病视网膜病变患病率差异有统计学意义(P<0.05)。TIR四分位数与蛋白尿严重程度呈负相关(r=-0.407,P<0.001)。TIR越高,老年T2DM患者发生蛋白尿风险降低。结论TIR可能与老年T2DM患者蛋白尿的发病风险及严重程度有关。Objective To explore the relationship between time in target range(TIR)assessed by continuous glucose monitoring and proteinuria in elderly patients with type 2 diabetes mellitus(T2DM).Methods The clinical data of 176 elderly T2DM patients hospitalized in Eighth People s Hospital of Shanghai City from October 2016 to August 2020 were retrospectively analyzed.The patients were divided into normal albuminuria group(n=99),microalbuminuria group(n=51),and macroalbuminuria group(n=26)based on their urinary microalbumin/creatinine ratio.The general data and continuous blood glucose monitoring indexes of the 3 groups were compared.Spearman correlation coefficient analysis and multiple ordinal regression analysis were used to analyze the relationship between TIR quartile and the severity of diabetes albuminuria.Results There were significant differences among the three groups in gender,T2DM course,hypertension constituent ratio,smoking history,use of insulin,use of angiotensin converting enzyme inhibitor and angiotensinⅡreceptor blocker,use of statins,systolic blood pressure,total cholesterol,low-density lipoprotein cholesterol,estimated glomerular filtration rate,mean amplitude of glycemic excursion,TIR and prevalence of diabetes retinopathy(P<0.05).The quartiles of TIR were negatively correlated with the severity of proteinuria.The higher the TIR,the lower the risk of developing proteinuria in elderly T2DM patients.Conclusion TIR may be associated with the risk and severity of proteinuria in elderly T2DM patients.

关 键 词：老年 2型糖尿病 持续血糖监测 目标范围内时间 蛋白尿 

分 类 号：R587.2[医药卫生—内分泌] R696.2[医药卫生—内科学]