Department of Endocrinology and Metabolism, Zhongshan Hospital Affiliated to Xiamen University, Xiamen, PR China.
Diabetes Res Clin Pract. 2010 Oct;90(1):95-9. doi: 10.1016/j.diabres.2010.05.004. Epub 2010 Jun 3.
To evaluate the relationship between blood glucose fluctuations and carotid atherosclerosis (AS) in type 2 diabetic patients.
A case-control study included 36 patients with type 2 diabetes and 10 controls. According to the levels of carotid intima-media thickness (CIMT), 36 diabetic patients were classified into two groups, the diabetes mellitus without atherosclerosis (DM-AS, n=20) and diabetes mellitus with atherosclerosis (DM+AS, n=16). The glucose excursions were assessed by the following parameters obtained from continuous glucose monitoring system for 72h: the mean blood glucose (MBG) and its standard deviation (SD), the area under the ROC curve when the blood glucose was higher than 7.8mmol/L (AUC7.8), the mean amplitude of glycemic excursion (MAGE), the mean of daily differences (MODD), and the largest amplitude of glycemic excursion (LAGE).
The levels of MBG, SD, MAGE, LAGE, and AUC7.8 were gradually increased with the progression of atherosclerosis (P<0.05). The Spearman's correlation analysis showed that the CIMT was correlated to the age (R=0.58, P<0.001), the duration (R=0.50, P<0.001), the MAGE (R=0.34, P=0.021), and the LAGE (R=0.31, P=0.035).
These results suggest that glucose fluctuations may accelerate atherogenesis in older type 2 diabetic patients who had a longer duration.
评估 2 型糖尿病患者血糖波动与颈动脉粥样硬化(AS)的关系。
采用病例对照研究,纳入 36 例 2 型糖尿病患者和 10 例对照。根据颈动脉内膜中层厚度(CIMT)水平,将 36 例糖尿病患者分为两组:无动脉粥样硬化的糖尿病(DM-AS,n=20)和有动脉粥样硬化的糖尿病(DM+AS,n=16)。通过连续血糖监测系统获得的以下参数评估血糖波动:平均血糖(MBG)及其标准差(SD)、血糖高于 7.8mmol/L 时的 ROC 曲线下面积(AUC7.8)、血糖波动的平均幅度(MAGE)、日间血糖差的均值(MODD)和最大血糖波动幅度(LAGE)。
随着动脉粥样硬化的进展,MBG、SD、MAGE、LAGE 和 AUC7.8 的水平逐渐升高(P<0.05)。Spearman 相关分析显示,CIMT 与年龄(R=0.58,P<0.001)、病程(R=0.50,P<0.001)、MAGE(R=0.34,P=0.021)和 LAGE(R=0.31,P=0.035)相关。
这些结果表明,血糖波动可能加速病程较长的老年 2 型糖尿病患者的动脉粥样硬化形成。