血糖漂移与2型糖尿病视网膜病变发生的相关性

目的探讨血糖漂移与2型糖尿病视网膜病变(DR)发生的关系。方法对138例2型糖尿病患者根据眼底摄片结果分为无视网膜病变组(NDR)和糖尿病视网膜病变组(DR)。比较两组年龄、糖尿病病程、血压、空腹血糖、餐后血糖、糖化血红蛋白、尿白蛋白/肌酐、甘油三酯、胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、空腹C肽的水平。同时对两组患者进行连续72 h的动态血糖监测,观察两组间血糖波动指标的差异。最后采用Logistic回归分析DR与各因素的相关性。结果两组间患者的年龄、病程、平均血糖水平、日内平均血糖漂移幅度的差异均有统计学意义(P<0.01),Logistic分析结果显糖尿病病程、日内平均血糖漂移幅度是DR的独立危险因素(P<0.01),但平均血糖水平是否为其独立危险因素尚不能确定(P=0.05)。结论糖尿病病程、日内平均血糖漂移幅度是2型糖尿病患者发生DR的独立危险因素,血糖波动可加剧DR病变进展,应及早干预。

Associations between amplitude of glycemic excursion and retinopathy in type 2 diabetic

Objective To investigate the amplitude of glycemic excursion and its relation with retinopathy in type 2 diabetic.Methods According to the fundus photographic results,138 cases of type 2 diabetic patients were classified to without retinopathy group(NDR) and diabetic retinopathy group(DR).Age,duration of diabetes,blood pressure(BP),fasting plasma glucose(FBG),postprandial plasma glucose(2hPG),glycosylated hemoglobin(HbA1c),urinary albumin/creatinine(A/C),triglyceride(TG),cholesterol(TC),high density lipoprotein(HDL-C),low density lipoprotein(LDL-C),fasting C peptide were compared in the two groups.At the same time the two group patients were measured by continuous glucose monitoring system(CGMS) for 72 h,and the blood glucose fluctuation index difference were observed in the two groups.Finally using the logistic regression analysis of DR and the related factors.Results Age,course of disease,the mean blood glucose level(MBG),days of mean amplitude of glycemic excursions(MAGE) were significant difference in the two groups(P<0.01).Logistic analysis results showed that duration of diabetes and MAGE was an independent risk factor of DR(P<0.01),but MBG whether or not the independent risk factor DR remained to deliberate(P=0.05).Conclusion Diabetic duration,MAGE is the independent risk factors of DR.Blood glucose fluctuation may aggravate the progression of DR,so it need early interention.