Department of Endocrinology and Metabolism, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital; Shanghai Clinical Center for Diabetes; Shanghai Diabetes Institute; Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, 200233, China.
Endocrine. 2022 Jun;76(3):593-600. doi: 10.1007/s12020-022-03038-3. Epub 2022 Mar 23.
Time in range (TIR) has surfaced as a key continuous glucose monitoring (CGM)-derived metric, which was linked to diabetes-related outcomes. We aimed to investigate the association of TIR with the risk of lower extremity atherosclerotic disease (LEAD) among patients with type 2 diabetes.
A total of 1351 adult patients with type 2 diabetes were prospectively recruited from a single center in Shanghai, China. TIR was obtained from CGM data at baseline. LEAD was measured with color Doppler ultrasonography. Cox proportion hazard regression analysis was used to assess the association between TIR and the risk of incident/progressive LEAD.
During a median follow-up of 7.4 years, 450 participants developed incident/progressive LEAD. The multivariable-adjusted hazard ratios (HRs) for incident/progressive LEAD across different levels of TIR ( > 85%, 7185%, 5170%, and ≤50%) were 1.00, 1.15 (95% confidence interval [CI] 0.87-1.52), 1.37 (95% CI 1.04-1.80) and 1.46 (95% CI 1.10-1.94) (P for trend = 0.004), respectively. With each 10% decrease in TIR, the multivariable-adjusted risk of incident/progressive LEAD increased by 7% (95% CI 1.02-1.11). Similar results were found in the association between TIR and incident LEAD as the secondary outcome (P for trend < 0.001).
The current study found an inverse association of TIR with the risk of LEAD among patients with type 2 diabetes.
时间在范围内（TIR）已经成为关键的连续血糖监测（CGM）衍生指标，与糖尿病相关结局相关。我们旨在研究 TIR 与 2 型糖尿病患者下肢动脉粥样硬化疾病（LEAD）风险之间的关联。
共前瞻性招募来自中国上海一家单中心的 1351 例 2 型糖尿病成年患者。TIR 从基线 CGM 数据中获得。LEAD 通过彩色多普勒超声测量。Cox 比例风险回归分析用于评估 TIR 与新发/进展性 LEAD 风险之间的关系。
在中位随访 7.4 年期间，450 名参与者发生新发/进展性 LEAD。TIR 不同水平（>85%、71-85%、51-70%和≤50%）下新发/进展性 LEAD 的多变量调整后的风险比（HRs）分别为 1.00、1.15（95%置信区间 [CI] 0.87-1.52）、1.37（95% CI 1.04-1.80）和 1.46（95% CI 1.10-1.94）（趋势 P=0.004）。TIR 每降低 10%，新发/进展性 LEAD 的多变量调整风险增加 7%（95% CI 1.02-1.11）。在 TIR 与二级结局（趋势 P<0.001）之间的关联中也发现了类似的结果。
本研究发现 TIR 与 2 型糖尿病患者 LEAD 风险呈负相关。
