葡萄糖在目标范围内时间与2型糖尿病患者心脏自主神经病变的相关性研究

目的 研究葡萄糖在目标范围内时间(TIR)与2型糖尿病患者心脏自主神经病变(DCAN)的相关性.方法 选取2019年11月至2021年3月在安徽医科大学附属合肥医院内分泌科住院的343例2型糖尿病患者,根据Ewing试验结果将患者分为糖尿病心脏自主神经病变组(DCAN组,n=201)与无糖尿病心脏自主神经病变组(NDC...

Relationship between time in rangeand diabetic cardiac autonomic neuropathy in patients with type 2 diabetes

Objective To study the relationship between time in range (TIR) and diabetic cardiac autonomic neuropathy (DCAN) in patients with type 2 diabetes mellitus. Methods A total of 343 patients with type 2 diabetes who were hospitalized in the Department of Endocrinology, Hefei Hospital Affiliated to Anhui Medical University from November 2019 to March 2021 were selected. According to the results of Ewing test, the patients were divided into two groups:diabetic cardiac autonomic neuropathy group (DCAN group, n=201) and non-diabetic cardiac autonomic neuropathy group (NDCAN group, n=142). The differences of clinical basic data and multiple indexes between the two groups were compared. Multivariate Logistic regression was used to analyze the risk factors of DCAN patients. The predictive value of influencing factors to DCAN was analyzed by subject working characteristic (ROC) curve.Results The age, course of diabetes mellitus, UACR, MAGE, SD, CV and MG in DCAN group were higher than those in NDCAN group, while TIR index was lower than that in NDCAN group(P<0.05).Logistic regression analysis showed that the course of diabetes mellitus and MAGE were the risk factors of DCAN (odds ratio 1.055, 1.319 respectively), and TIR was the protective factor (odds ratio, 0.963). The ROC curve showed that the area under the curve (AUC) of diabetes mellitus course prediction DCAN was 0.643, the critical value was 4.50 years, the sensitivity and specificity was 72.60% and 53.50%, respectively, and the AUC of MAGE prediction DCAN was 0.630, the critical value was 4.46 mmol/L, the sensitivity and specificity was 50.70% and 69.0%, respectively, the AUC of DCAN prediction was 0.684, and the critical value was 76.48%. The sensitivity and specificity was 71.10% and 59.20% respectively (P<0.05).Conclusion TIR is closely related to the incidence of DCAN in patients with type 2 diabetes and is a protective factor. The acquisition of TIR data is helpful to the clinical risk assessment of DCAN.