一项关于血糖控制达标时间与 2 型糖尿病周围神经病变的回顾性研究。
A Retrospective Study on the Time in Range of Blood Glucose and Type 2 Diabetic Peripheral Neuropathy.
机构信息
Endocrine Department, First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin 150000, China.
Isotope Department, First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin 150000, China.
出版信息
Biomed Res Int. 2022 Jul 28;2022:2743679. doi: 10.1155/2022/2743679. eCollection 2022.
BACKGROUND
Time in range (TIR) is one of the basic indicators to assess glycemic control. In this study, the TIR of DPN patients was used as the observation index to further evaluate the correlation between TIR and DPN, so as to provide new ideas for preventing the occurrence of DPN and delaying its disease progression.
METHODS
A total of 120 patients with T2DM (T2DM) who were hospitalized in the Endocrinology Department of our hospital from October 2018 to February 2020 were included and divided into two groups according to whether the nerve conduction velocity was normal or not, the diabetic peripheral neuropathy group (DPN) and the other groups. No diabetic peripheral neuropathy group (NDPN). According to the corresponding inclusion and exclusion criteria, the baseline data were recorded, and test indicators such as homocysteine and blood lipids were collected at the same time, and TIR was collected by a transient blood glucose meter. To explore the relationship between TIR and other indicators and peripheral neuropathy in T2DM.
RESULTS
A total of 120 T2DM patients participated in the study, including 82 in the DPN group and 38 in the NDPN group. There were no statistically significant differences in basic indicators such as age, height, and weight between the two groups. Glycated hemoglobin (HbA1c) and homocysteine (Hcy) in DPN group were higher than those in NDPN group, while TIR and HDL-C were lower than those in NDPN group ( < 0.05). Logistic regression analysis showed that HbA1c and Hcy were risk factors for DPN, and TIR and HDL-C were protective factors for DPN, with statistical significance ( < 0.05). The prediction results of TIR, Hcy, HDL-C, and HbA1c on diabetic peripheral neuropathy were analyzed by ROC curve, and the prediction results of the five variables were all statistically significant ( < 0.05) and have a better prediction effect.
CONCLUSION
(1) The results of TIR level suggest that the longer the blood sugar is in the good control range, the more beneficial it is to reduce the occurrence of DPN. (2) TIR and HDL-C are protective factors for DPN, and HbA1c and Hcy are risk factors for DPN. (3) The results of ROC curve analysis showed that TIR, Hcy, HbA1c, and HDL-C had a good predictive effect on the occurrence of DPN.
背景
时间在范围内（TIR）是评估血糖控制的基本指标之一。在本研究中，DPN 患者的 TIR 被用作观察指标，以进一步评估 TIR 与 DPN 的相关性，为预防 DPN 的发生和延缓其疾病进展提供新的思路。
方法
选取 2018 年 10 月至 2020 年 2 月在我院内分泌科住院的 120 例 T2DM 患者为研究对象，根据神经传导速度是否正常分为两组，即糖尿病周围神经病变组（DPN）和其他组（无糖尿病周围神经病变组（NDPN）。根据相应的纳入和排除标准，记录基线资料，同时采集同型半胱氨酸和血脂等检测指标，采用瞬态血糖仪采集 TIR。探讨 TIR 与其他指标与 T2DM 周围神经病变的关系。
结果
共纳入 120 例 T2DM 患者，其中 DPN 组 82 例，NDPN 组 38 例。两组患者年龄、身高、体重等基本指标比较差异无统计学意义。DPN 组糖化血红蛋白（HbA1c）和同型半胱氨酸（Hcy）高于 NDPN 组，TIR 和高密度脂蛋白胆固醇（HDL-C）低于 NDPN 组（ < 0.05）。Logistic 回归分析显示，HbA1c 和 Hcy 是 DPN 的危险因素，TIR 和 HDL-C 是 DPN 的保护因素，差异有统计学意义（ < 0.05）。ROC 曲线分析 TIR、Hcy、HDL-C、HbA1c 对糖尿病周围神经病变的预测结果，五变量预测结果均有统计学意义（ < 0.05），预测效果较好。
结论
（1）TIR 水平的结果提示血糖在较好控制范围内的时间越长，越有利于减少 DPN 的发生。（2）TIR 和 HDL-C 是 DPN 的保护因素，HbA1c 和 Hcy 是 DPN 的危险因素。（3）ROC 曲线分析结果显示，TIR、Hcy、HbA1c、HDL-C 对 DPN 的发生有较好的预测效果。
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