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2型糖尿病患者血糖变异性指标与血管结局的关联:一项回顾性研究。

Association of various glycemic variability indices and vascular outcomes in type-2 diabetes patients: A retrospective study.

作者信息

Tong Lei, Chi Chen, Zhang Zhiguo

机构信息

Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai Clinical Center for Endocrine and Metabolic Diseases, State Key Laboratory of Medical, Economics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.

出版信息

Medicine (Baltimore). 2018 May;97(21):e10860. doi: 10.1097/MD.0000000000010860.

Abstract

Both blood glucose (BG) level and glycemic variability (GV) significantly associate with diabetes-related complications. However, the criterion standard in GV assessment is absent. We aimed to compare different GV indices in association of vascular outcomes.Ten commonly used GV indices based on self-monitored BG data were calculated, and their associations of vascular outcomes including coronary artery disease (CAD), stroke, and chronic kidney disease (CKD) were compared.In total, 288 type 2 diabetes patients (66.5 ± 11.1 years old) were included in present analysis. Spearman correlation analysis showed that only mean amplitude of glycemic excursions (MAGE) significantly correlated with both estimated glomerular filtration rate and urinary albumin creatinine ratio (P ≤ .03). In Cochran-Armitage trend test, vascular outcomes were significantly associated with the increment of BG risk index and MAGE (P ≤ .03). After adjustment for potential confounders, multiple logistic regression results suggested that BG risk index and MAGE still significantly associated with these three vascular outcomes (P ≤ .01), whereas the other GV indices did not. Receiver operating characteristic curve analysis showed that the abilities of BG risk index and MAGE were similar in identifying CAD, stroke, or CKD.BG risk index and MAGE were better associated with vascular outcomes than other GV indices in type 2 diabetes patients.

摘要

血糖(BG)水平和血糖变异性(GV)均与糖尿病相关并发症显著相关。然而,GV评估的标准方法尚不存在。我们旨在比较不同GV指标与血管结局的相关性。计算了基于自我监测BG数据的10种常用GV指标,并比较了它们与包括冠状动脉疾病(CAD)、中风和慢性肾脏病(CKD)在内的血管结局的相关性。本分析共纳入288例2型糖尿病患者(66.5±11.1岁)。Spearman相关性分析显示,仅血糖波动幅度平均值(MAGE)与估算肾小球滤过率和尿白蛋白肌酐比值均显著相关(P≤0.03)。在Cochran-Armitage趋势检验中,血管结局与BG风险指数和MAGE的升高显著相关(P≤0.03)。在对潜在混杂因素进行校正后,多因素logistic回归结果表明,BG风险指数和MAGE仍与这三种血管结局显著相关(P≤0.01),而其他GV指标则不然。受试者工作特征曲线分析表明,BG风险指数和MAGE在识别CAD、中风或CKD方面的能力相似。在2型糖尿病患者中,BG风险指数和MAGE与血管结局的相关性优于其他GV指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f6c0/6392700/f0df40815ea3/medi-97-e10860-g006.jpg

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