Akintola Abimbola A, Noordam Raymond, Jansen Steffy W, de Craen Anton J, Ballieux Bart E, Cobbaert Christa M, Mooijaart Simon P, Pijl Hanno, Westendorp Rudi G, van Heemst Diana
Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the Netherlands.
Department of Clinical Chemistry, Leiden University Medical Center, Leiden, The Netherlands.
PLoS One. 2015 Oct 7;10(10):e0139973. doi: 10.1371/journal.pone.0139973. eCollection 2015.
The validity of continuous glucose monitoring (CGM) is well established in diabetic patients. CGM is also increasingly used for research purposes in normo-glycemic individuals, but the CGM validity in such individuals is unknown. We studied the accuracy of CGM measurements in normo-glycemic individuals by comparing CGM-derived versus venous blood-derived glucose levels and measures of glycemia and glycemic variability.
In 34 healthy participants (mean age 65.7 years), glucose was simultaneously measured every 10 minutes, via both an Enlite® CGM sensor, and in venous blood sampled over a 24-hour period. Validity of CGM-derived individual glucose measurements, calculated measures of glycemia over daytime (09:00h-23:00h) and nighttime (23:00h-09:00h), and calculated measures of glycemic variability (e.g. 24h standard deviation [SD]) were assessed by Pearson correlation coefficients, mean absolute relative difference (MARD) and paired t-tests.
The median correlation coefficient between CGM and venous glucose measurements per participant was 0.68 (interquartile range: 0.40-0.78), and the MARD was 17.6% (SD = 17%). Compared with venous sampling, the calculated measure of glycemia during daytime was 0.22 mmol/L higher when derived from CGM, but no difference was observed during nighttime. Most measures of glycemic variability were lower with CGM than with venous blood sampling (e.g., 24h SD: 1.07 with CGM and 1.26 with venous blood; p-value = 0.004).
In normo-glycemic individuals, CGM-derived glucose measurements had good agreement with venous glucose levels. However, the measure of glycemia was higher during the day and most measures of glycemic variability were lower when derived from CGM.
连续血糖监测(CGM)在糖尿病患者中的有效性已得到充分证实。CGM也越来越多地用于血糖正常个体的研究目的,但此类个体中CGM的有效性尚不清楚。我们通过比较CGM得出的血糖水平与静脉血得出的血糖水平以及血糖和血糖变异性指标,研究了血糖正常个体中CGM测量的准确性。
在34名健康参与者(平均年龄65.7岁)中,每10分钟同时通过Enlite® CGM传感器和在24小时内采集的静脉血测量一次血糖。通过Pearson相关系数、平均绝对相对差异(MARD)和配对t检验评估CGM得出的个体血糖测量值、白天(09:00h - 23:00h)和夜间(23:00h - 09:00h)血糖的计算指标以及血糖变异性的计算指标(例如24小时标准差[SD])的有效性。
每位参与者的CGM与静脉血糖测量值之间的中位数相关系数为0.68(四分位间距:0.40 - 0.78),MARD为17.6%(标准差 = 17%)。与静脉采血相比,CGM得出的白天血糖计算指标比静脉血高0.22 mmol/L,但夜间未观察到差异。大多数血糖变异性指标CGM低于静脉血采样(例如,24小时SD:CGM为1.07,静脉血为1.26;p值 = 0.004)。
在血糖正常个体中,CGM得出的血糖测量值与静脉血糖水平具有良好的一致性。然而,白天的血糖测量指标较高,且大多数血糖变异性指标CGM较低。