2型糖尿病患者血糖波动与糖尿病视网膜病变的相关性研究

[目的]探讨2型糖尿病(T2DM)患者血糖波动与糖尿病视网膜病变(DR)的相关性.[方法]T2DM患者进行眼底照相或眼底荧光造影,根据DR程度分为无视网膜病变(NDR)组、糖尿病背景型视网膜病变(BDR)组、糖尿病增殖型视网膜病变(PDR)组,记录性别、年龄、病程,测量血压、体重指数、糖化血红蛋白、空腹及餐后2h胰岛素、空腹及餐后2h C肽及血脂指标.选取三组中上述基线指标具可比性的病例共106例(NDR组33例,BDR组38例,PDR组35例)纳入观察.采用动态血糖监测系统(CGMS)连续监测患者血糖72 h.[结果]各组间平均血糖水平(MBG)、血糖标准差(SDBG)、平均血糖波动幅度(MAGE)及血糖波动最大幅度(LAGE)相比较有统计学差异(P＜0.05).Spearman相关分析显示,DR与MBG、SDBG、MAGE及LAGE呈正相关(P＜0.05).校正MBG后,DR与SDBG、MAGE及LAGE的相关系数分别为0.297、0.396、0.284(P ＜0.01).[结论]血糖波动与DR的发生发展有关,应尽早干预.

Correlation Between Glucose Variability and Diabetic Retinopathy in Patients with Type 2 Diabetes Mellitus

[Objective] To explore the relationship between glucose variability and diabetic retinopathy （DR） in patients with type 2 diabetes mellitus（T2DM）. [Methods] Fundus photography or fundus fluorescein angiography were performed for T2DM patients. According to the degree of DR, all patients were divided into non-DR group（NDR group）, background DR group（BDR group） and proliferative DR group（PDR group）. The gender, age and course of disease were recorded. Blood pressure, body mass index, glycosylated hemo- globin, fasting and postprandial 2h-insulin, fasting and postprandial 2hCpeptide and blood lipid indicators were measured. A total of 106 patients with comparable above basal indicators were chosen from 3 groups（33 patients in NDR group, 38 patients in BDR group and 35 patients in PDR group） and enrolled in the study. Dynamic blood glucose monitoring system（CGMS） was used for monitoring blood glucose of patients continu- ously for 72h. [Results] There were significant differences in mean blood glucose（MBG）, standard deviation of blood glucose（SDBG）, mean amplitude of glycemic exeursions（MAGE） and maximal amplitude of glycermic excursions（LAGE） among groups（ P d0.05）. Spearman correlation analysis indicated that DR was positively correlated with MBG, SDBG, MAGE and LAGE（ P d0.05）. After adjustment of MBG, the correlation coef ficient between DR and SDBG, MAGE, LAGE was 0. 297, 0. 396 and 0. 284, respectively（ P d0.01）. [Con clusion] Blood glucose variability is associated with the genesis and development of DR. Early intervention should be taken.