Servicio de Medicina Interna, Hospital Universitario de Mostoles, Rio Jucar s/n, Mostoles, 28935 Madrid, Spain.
European University of Madrid, Villaviciosa de Odón, Spain.
J Diabetes Res. 2016;2016:9361958. doi: 10.1155/2016/9361958. Epub 2016 May 16.
Detrended Fluctuation Analysis (DFA) measures the complexity of a glucose time series obtained by means of a Continuous Glucose Monitoring System (CGMS) and has proven to be a sensitive marker of glucoregulatory dysfunction. Furthermore, some authors have observed a crossover point in the DFA, signalling a change of dynamics, arguably dependent on the beta-insular function. We investigate whether the characteristics of this crossover point have any influence on the risk of developing type 2 diabetes mellitus (T2DM). To this end we recruited 206 patients at increased risk of T2DM (because of obesity, essential hypertension, or a first-degree relative with T2DM). A CGMS time series was obtained, from which the DFA and the crossover point were calculated. Patients were then followed up every 6 months for a mean of 17.5 months, controlling for the appearance of T2DM diagnostic criteria. The time to crossover point was a significant predictor risk of developing T2DM, even after adjusting for other variables. The angle of the crossover was not predictive by itself but became significantly protective when the model also considered the crossover point. In summary, both a delay and a blunting of the crossover point predict the development of T2DM.
去趋势波动分析（DFA）通过连续血糖监测系统（CGMS）测量葡萄糖时间序列的复杂性，并已被证明是检测糖调节功能障碍的敏感标志物。此外，一些作者观察到 DFA 中的交叉点，这表明动态发生变化，可能依赖于β胰岛功能。我们研究了这个交叉点的特征是否对发展 2 型糖尿病（T2DM）的风险有任何影响。为此，我们招募了 206 名 T2DM 风险增加的患者（肥胖、原发性高血压或 T2DM 一级亲属）。获得 CGMS 时间序列，从中计算 DFA 和交叉点。然后，患者平均随访 17.5 个月，每 6 个月随访一次，同时控制 T2DM 诊断标准的出现。到达交叉点的时间是发展为 T2DM 的显著风险预测因素，即使在调整了其他变量后也是如此。交叉角本身没有预测能力，但当模型同时考虑交叉点时，它变得具有显著的保护作用。总之，交叉点的延迟和钝化都预示着 T2DM 的发展。
