血糖目标范围内时间和糖化血红蛋白与2型糖尿病微血管病变的相关性研究

史琼; 王静; 陆明

doi:10.13898/j.cnki.issn.1000-2200.2023.04.014

血糖目标范围内时间和糖化血红蛋白与2型糖尿病微血管病变的相关性研究

Correlation of time in range and glycosylated hemoglobin with diabetic microvascular complication in type 2 diabetes mellitus

摘要

摘要:
目的探讨血糖目标范围内时间(TIR)、血糖波动性、糖化血红蛋白(HbA1c)与2型糖尿病微血管病变(DMAP)的关系。
方法根据有无糖尿病视网膜病变和糖尿病肾病, 将142例2型糖尿病(T2DM)病人分为DMAP组和对照组(NDMAP组)。比较2组的一般临床资料、实验室资料和动态血糖指标。使用Spearman相关分析DMAP与各指标的相关性。使用二元logistic回归分析病人DMAP的影响因素。使用受试者工作特征曲线(ROC曲线)评估HbA1c、TIR对DMAP的预测价值。
结果DMAP组和NDMAP组比较, 病程、HbA1c、总胆固醇(TC)、血糖标准差(SDBG)、平均血糖(MBG)、平均血糖波动幅度(MAGE)、TIR差异均有统计学意义(P < 0.05~P < 0.01)。Spearman相关分析显示: DMAP与TIR水平呈负相关关系(r=-0.424, P < 0.01), 与HbA1c、MBG、SDBG、MAGE呈正相关关系(r=0.471, 0.314, 0.371, 0.233, P < 0.01)。二元logistic回归分析显示, HbA1c是DMAP的危险因素, TIR是DMAP的保护因素。ROC曲线分析显示, HbA1c、TIR预测DMAP发生风险的ROC曲线下面积分别为0.792和0.763。
结论HbA1c、TIR均与DMAP相关, 且可预测DMAP发生的风险。

Abstract:
ObjectiveTo explore the relationship among the time in range (TIR), fluctuation of blood glucose, glycated hemoglobin (HbA1c) and microangiopathy in type 2 diabetes mellitus(T2DM).
MethodsA total of 142 patients with T2DM were divided into the diabetic microangiopathy group (DMAP group) and the control group (NDMAP group) according to their diabetic retinopathy and diabetic nephropathy.The general clinical data, laboratory data and dynamic blood glucose index were compared between the two groups.Spearman correlation analysis was used to analyze the correlation between DMAP and each index.The influencing factors of DMAP were analyzed by binary logistic regression analysis.The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of HbA1c and TIR for DMAP.
ResultsThere were significant differences in the course of disease, HbA1c, cholesterol (TC), blood glucose standard deviation (SDBG), mean blood glucose (MBG), mean amplitude of glycemic excursions (MAGE) and TIR between the DMAP group and NDMAP group(P < 0.05 to P < 0.01).Spearman correlation analysis showed that DMAP was negatively correlated with TIR (r=-0.424, P < 0.01), and positively correlated with HbA1c, MBG, SDBG and MAGE (r= 0.471, 0.314, 0.371, 0.233, P < 0.01).Binary logistic regression analysis showed that HbA1c was a risk factor for DMAP and TIR was a protective factor for DMAP.ROC curve analysis results showed that the area under the ROC curve for HbA1c and TIR was 0.792 and 0.763, respectively.
ConclusionsHbA1c and TIR are both related to DMAP, which can predict the risk of DMAP.

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