Ji Sheng-Han, Dong Chen, Chen Rou, Shen Chen-Chen, Xiao Jing, Gu Yun-Juan, Gao Jian-Lin
Department of Endocrinology and Metabolism, Affiliated Hospital of Nantong University, Nantong, China.
Medical School of Nantong University, Nantong University, Nantong, China.
Front Nutr. 2022 Jul 8;9:955101. doi: 10.3389/fnut.2022.955101. eCollection 2022.
Large fluctuations in blood glucose levels greatly impact the health and life span of elderly individuals. This study describes the characteristics of variability in glycemic indices in centenarians with the aim of emphasizing the importance of glycemic variability in elderly people.
We recruited individuals from Rugao City, Jiangsu Province, China from April 2020 to May 2021. The study cohort included 60 centenarians and 60 first-generation offspring, as well as 20 randomly selected non-cohabitant control individuals aged 60-80 years. A FreeStyle Libre H (hospital version) continuous glucose monitoring (CGM) device (Abbott Ireland UK) was used to measure glycemic variability. The indices measured included the time in target glucose range (TIR), time below target glucose range (TBR), time above target glucose range (TAR), mean amplitude of glycemic excursions (MAGE), mean of daily differences (MODD), coefficient of variation (CV), standard deviation of blood glucose (SDBG), continuous overlapping net glycemic action (CONGA), glucose management indicator (GMI) and estimated glycated hemoglobin (eHbA1c). Logistic regression was used to analyze the association between glycemic variability and longevity.
Mean blood glucose (MBG), eHbA1c, GMI, mean fasting plasma glucose (M-FPG) and CONGA were lower in the centenarian group ( all < 0.05). PPGE-2 was higher in the control group than that measured in the centenarian and first-generation offspring groups ( < 0.05). There were no differences between the groups in MAGE, MODD, MAG, or TIR ( > 0.05). The risk of not achieving longevity increased with each one unit increase in MBG by 126% [2.26 (1.05-4.91)], eHbA1c by 67% [1.67 (1.03-2.72)], GMI by 568% [6.68 (1.11-40.30)], M-FPG by 365% [4.65 (1.57-13.75)], M-PPG1h by 98% [1.98 (1.18-3.31)], CONGA1 by 102% [2.02 (1.01-4.06)], Li by 200% [3.00 (1.04-8.61)], and PPGE-2 by 150% [2.50 (1.39-4.50)]. However, the risk of achieving longevity decreased with each unit increase of LBGI by 53% [0.47 (0.28-0.80)], ADRR by 60% [0.40 (0.18-0.86)], and TBR by 11% [0.89 (0.80-0.98)].
Fluctuation in blood glucose levels in centenarians is relatively small. Maintaining an average blood glucose level and keeping blood glucose fluctuations in the normal range is conducive to longevity.
血糖水平的大幅波动对老年人的健康和寿命有很大影响。本研究描述了百岁老人血糖指数变异性的特征，旨在强调血糖变异性在老年人中的重要性。
我们于2020年4月至2021年5月从中国江苏省如皋市招募研究对象。研究队列包括60名百岁老人和60名第一代后代，以及20名随机选择的年龄在60 - 80岁的非同居对照个体。使用FreeStyle Libre H（医院版）连续血糖监测（CGM）设备（雅培爱尔兰英国公司）测量血糖变异性。测量的指标包括血糖目标范围内时间（TIR）、低于血糖目标范围时间（TBR）、高于血糖目标范围时间（TAR）、血糖波动平均幅度（MAGE）、每日差异均值（MODD）、变异系数（CV）、血糖标准差（SDBG）、连续重叠净血糖作用（CONGA）、血糖管理指标（GMI）和估计糖化血红蛋白（eHbA1c）。采用逻辑回归分析血糖变异性与长寿之间的关联。
百岁老人组的平均血糖（MBG）、eHbA1c、GMI、平均空腹血糖（M - FPG）和CONGA较低（均P < 0.05）。对照组的PPGE - 2高于百岁老人组和第一代后代组（P < 0.05）。各组在MAGE、MODD、MAG或TIR方面无差异（P > 0.05）。MBG每增加1个单位，未达到长寿的风险增加126% [2.26（1.05 - 4.91）]；eHbA1c每增加1个单位，风险增加67% [1.67（1.03 - 2.72）]；GMI每增加1个单位，风险增加568% [6.68（1.11 - 40.30）]；M - FPG每增加1个单位，风险增加365% [4.65（1.57 - 13.75）]；M - PPG1h每增加1个单位，风险增加98% [1.98（1.18 - 3.31）]；CONGA1每增加1个单位，风险增加102% [2.02（1.01 - 4.06）]；Li每增加1个单位，风险增加200% [3.00（1.04 - 8.61）]；PPGE - 2每增加1个单位，风险增加150% [2.50（1.39 - 4.50）]。然而，LBGI每增加1个单位，达到长寿的风险降低53% [0.47（0.28 - 0.80）]；ADRR每增加1个单位，风险降低60% [0.40（0.18 - 0.86）]；TBR每增加1个单位，风险降低11% [0.89（0.80 - 0.98）]。
百岁老人血糖水平的波动相对较小。维持平均血糖水平并使血糖波动保持在正常范围内有利于长寿。
