HbA1c正常的2型糖尿病患者葡萄糖目标范围内时间与颈动脉斑块的相关性  

Correlation between the Time in Range of Glucose and Carotid Plaque in Patients of Type 2 Diabetes Mellitus with Normal HbA1c

作　　者：方杜娟 刘尚全[1] FANG Dujuan;LIU Shangquan(Department of Endocrinology,Hefei First People's Hospital(the Third Affiliated Hospital of Anhui Medical University),Hefei 230000,Anhui,China)

机构地区：[1]合肥市第一人民医院(安徽医科大学第三附属医院)内分泌科,安徽合肥230000

出　　处：《糖尿病新世界》2024年第22期22-25,37,共5页Diabetes New World

摘　　要：目的 探究糖化血红蛋白(glycated hemoglobin A1c, HbA1c)正常的2型糖尿病患者发生颈动脉斑块的影响因素。方法 回顾性选取2023年5月—2024年4月合肥市第一人民医院收治的152例HbA1c<7.0%的2型糖尿病患者的临床资料,根据颈动脉超声结果,分为斑块组(86例)和无斑块组(66例)。单因素分析两组患者一般临床资料的差异,并采用二元Logistic回归分析HbA1c正常的2型糖尿病患者发生颈动脉斑块的影响因素。结果 两组性别、吸烟史、糖尿病家族史、舒张压、谷氨酰氨基转移酶、谷草转氨酶、胆固醇、高密度脂蛋白、低密度脂蛋白、尿酸、肌酐、尿素氮、甘油三酯、空腹血糖、空腹C肽比较,差异均无统计学意义(P均>0.05)。两组年龄、病程、收缩压、胱抑素C、肾小球滤过率、葡萄糖目标范围内时间(time in range, TIR)比较,差异均有统计学意义(P均<0.05)。二元Logistic回归分析结果显示,葡萄糖TIR≥85%是颈动脉斑块发生的保护因素;年龄≥60岁、病程≥10年、胱抑素C≥0.9 mg/L是颈动脉斑块发生的危险因素(P均<0.05)。结论 对于HbA1c正常的2型糖尿病患者,葡萄糖TIR、年龄、病程、胱抑素C水平是发生颈动脉斑块的影响因素。Objective To explore the influencing factors of carotid plaque in patients of type 2 diabetes mellitus with normal glycated hemoglobin A1c(HbA1c).Methods The clinical data of 152 patients of type 2 diabetes mellitus with HbA1c<7.0%admitted to Hefei First People's Hospital from May 2023 to April 2024 were retrospectively selected.According to the results of carotid ultrasound,they were divided into plaque group(86 cases)and non-plaque group(66 cases).Univariate analysis was used to analyze the differences in general clinical data between the two groups.Bi-nary Logistic regression was used to analyze the influencing factors of carotid plaque in patients with type 2 diabetes mellitus with normal HbA1c.Results There were no significant differences in gender,smoking history,family history of diabetes,diastolic blood pressure,glutamyltransferase,aspartate aminotransferase,cholesterol,high-density lipopro-tein,low-density lipoprotein,uric acid,creatinine,urea nitrogen,triglyceride,fasting plasma glucose and fasting C-peptide between the two groups(all P>0.05).There were significant differences in age,course of disease,systolic blood pressure,cystatin C,glomerular filtration rate,and time in range(TIR)of glucose between the two groups(all P<0.05).Binary Logistic regression analysis showed that TIR of glucose≥85% was a protective factor for carotid plaque,age≥60 years old,course of disease≥10 years,cystatin C≥0.9 mg/L were risk factors for carotid plaque(all P<0.05).Conclusion For patients of type 2 diabetes mellitus with normal HbA1c,TIR of glucose,age,course of disease,and cystatin C level are the influencing factors of carotid plaque.

关 键 词：2型糖尿病 葡萄糖目标范围内时间 血糖波动 颈动脉斑块 

分 类 号：R587.2[医药卫生—内分泌]