2型糖尿病慢性血糖波动对动脉硬化的影响研究

目的探讨2型糖尿病(T2DM)患者慢性血糖波动对动脉硬化的影响。方法以30例施行过冠脉造影术的2型糖尿病患者为本研究对象,根据冠脉造影结果分为不合并心血管并发症组8例和合并心血管并发症组22例,并对研究对象行72 h动态血糖监测。结果 (1)两组研究对象的病程、平均血糖波动幅度(MAGE)、糖化血红蛋白(HbA1c)、C-反应蛋白(CRP)、颈动脉内膜中层厚度(IMT)以及胰岛素抵抗指数(HOMA-IR)、胰岛β细胞功能指数(HBCI)比较,差异均有统计学意义(P<0.05)。(2)MAGE与冠脉病变评分、IMT、CRP、HOMA-IR、HBCI均相关(P<0.05);冠脉病变评分、IMT分别与CRP、HOMA-IR、HBCI相关(P<0.05)。结论慢性血糖波动与2型糖尿病患者动脉粥样硬化有关;胰岛素抵抗、胰岛β细胞功能缺陷以及氧化应激可能在上述过程中发挥作用。

Impact of Chronic Glucose Fluctuation on Atherosclerosis in Type2 Diabetes Mellitus

Objective To investigate the impact of chronic glucose fluctuation on atherosclerosis in type2 diabetes mellitus(T2DM).Methods Thirty patients with T2DM who had undergone coronary angiography were included in the study.According to coronary angiography results,they were divided into two groups: with cardiovascular complications(n=22) and not with cardiovascular complications(n=8).72 h continuous glucose monitoring(CGM) was applied on all the subjects.Results(1)The course of disease,the mean amplitude of glycemic excursions(MAGE),HbA1c,C-reactive protein(CRP),carotid intima-media thickness(IMT),insulin resistance index(HOMA-IR),β-cell function index(HBCI)were significantly different between the two groups(P<0.05).(2)MAGE is correlated with coronary scores,IMT,CRP,HOMA-IR and HBCI(P<0.05);Coronary scores and IMT were respectively correlated with CRP,HOMA-IR,HBCI(P<0.05).Conclusion Chronic blood glucose fluctuation is related to atherosclerosis;insulin resistance,β-cell function defect and oxidative stress may play a role in the above process.