摘要
背景目标范围内时间(TIR)作为血糖管理的新指标,与短期血糖波动相关,是否与长期血糖变异性相关尚不清楚。目的探讨老年男性2型糖尿病患者TIR与长期随访期间糖化血红蛋白(HbA_(1c))变异系数、HbA_(1c)变异性评分(HVS)的关系。方法选取2007年1月至2011年1月在解放军总医院第二医学中心住院行动态血糖监测(CGM)的老年男性2型糖尿病患者200例,根据患者基线TIR水平,将其分为TIR≥85%组(n=141)和TIR<85%组(n=59)。对受试者随访观察(12.5±1.1)年,比较两组长期随访期间HbA_(1c)变异系数和HVS。采用Pearson相关、多元线性回归分析TIR与HbA_(1c)变异系数、HVS的关系。结果TIR<85%组患者的长期HbA_(1c)变异系数〔(9.7±3.8)%比(8.2±4.5)%,(P=0.028)〕、HVS〔(48.7±20.4)分比(32.5±20.8)分,(P<0.001)〕均明显高于TIR≥85%组。Pearson相关分析结果显示,TIR与长期HbA_(1c)变异系数(r=-0.239,P<0.001)、HVS(r=-0.400,P<0.001)呈线性负相关。多元线性回归分析结果显示,在调整混杂因素后,TIR对长期HbA_(1c)变异系数、HVS有影响〔b(95%CI)分别为-0.07(-0.12,-0.03)、-0.44(-0.67,-0.21),P<0.05〕。结论老年男性2型糖尿病患者TIR与长期随访期间HbA_(1c)变异系数、HVS相关。TIR越低的患者,长期血糖变异性越明显。
Background As a new indicator of glycemic management,time in range(TIR)is significantly related to short-term glycemic variability,but whether it is also associated with long-term glycemic variability is still unclear.Objective To investigate the relationship of TIR with coefficient of variability(CV)of HbA_(1c) and HbA_(1c) variability score(HVS)during a long-term follow-up in elderly male patients with type 2 diabetes.Methods Two hundred elderly male type 2 diabetic inpatients from the Second Medical Center of PLA General Hospital were enrolled from January 2007 to January 2011.All of them underwent continuous glucose monitoring(CGM)during hospitalization,and by the baseline TIR derived from CGM,they were divided into TIR≥85%group(n=141)and TIR<85%group(n=59),and followed up for(12.5±1.1)years.The CV of HbA_(1c) and HVS in the follow-up were compared between the groups.The relationships of TIR with the CV of HbA_(1c) and HVS were analyzed using Pearson correlation analysis and multivariate linear regression analysis.Results The long-term CV of HbA_(1c)〔(9.7±3.8)%vs(8.2±4.5)%,P=0.028〕and HVS〔(48.7±20.4)vs(32.5±20.8),P<0.001〕in TIR<85%group were both significantly higher than those in TIR≥85%group.Pearson correlation analysis suggested that TIR showed a significant linear negative correlation with CV of HbA_(1c)(r=-0.239,P<0.001)or HVS(r=-0.400,P<0.001).Multiple linear regression analysis indicated that TIR had an impact on long-term CV of HbA_(1c)〔b(95%CI)=-0.07(-0.12,-0.03),P<0.05〕or HVS〔b(95%CI)=-0.44(-0.67,-0.21),P<0.05〕after adjusting for confounding factors.Conclusion TIR was independently associated with long-term CV of HbA_(1c) or HVS in elderly male patients with type 2 diabetes.With the decrease of TIR,the long-term HbA_(1c) glycemic variability increased gradually during follow-up.
作者
方福生
刘星宇
闫双通
王宁
李春霖
田慧
FANG Fusheng;LIU Xingyu;YAN Shuangtong;WANG Ning;LI Chunlin;TIAN Hui(Health Care Department 1,the Second Medical Center,Chinese PLA General Hospital,Beijing 100853,China;Department of Endocrinology,the Second Medical Center,Chinese PLA General Hospital,Beijing 100853,China;Department of Health Management,the Second Medical Center,Chinese PLA General Hospital,Beijing 100853,China)
出处
《中国全科医学》
CAS
北大核心
2023年第16期1979-1983,共5页
Chinese General Practice