糖化血红蛋白达标的2型糖尿病患者血糖波动与尿白蛋白/肌酐的关系探讨

目的 探讨糖化血红蛋白（HbA1c）达标的2型糖尿病患者血糖波动与尿白蛋白/尿肌酐（UACR）的关系。方法 选择合肥市第二人民医院2010年8月至2016年3月收治的2型糖尿病患者（HbA1c<7.0%）107例，根据UACR结果分为正常组21例（NUA组）和升高组86例（MUA组）。动态血糖监测系统（CGMS）对受试者进行连续72 h的血糖监测，计算出平均血糖（MBG）和平均血糖波动幅度（MAGE），同时检测血肌酐（Scr）、谷丙转氨酶（ALT），测量血压和计算体质指数（BMI）。结果 MUA组MAGE显著高于NUA组，差异有统计学意义（P<0.05）。MAGE与年龄、病程、Scr、UACR呈中度相关（P<0.05），与收缩压、舒张压、BMI、ALT呈低度相关（P<0.05）。结论 血糖控制达标的2型糖尿病患者尿白蛋白排泄增加与血糖波动有关。

Type 2 diabetes mellitus in glycosylated hemoglobin target blood glucose fluctuation and the relationship between urinary albumin/creatinine

Objective To explore the relationship between blood glucose fluctuation and urinary albumin excretion rate(UACR)in type 2 diabetic patients attaining glycosylated hemoglobin(HbA1c)standard.Methods A total of 107 patients with type 2 diabetes,HbA1c<7.0% were divided into NUA group(n=21) and MUA group(n=86) according to UACR.The fluctuating feature of 72 hours blood glucose of all the patients were recorded by continuous glucose monitoring system(CGMS),then CGMS parameters including mean blood glucose(MBG)and mean amplitude of glycemic excursions(MAGE)were calcalated and the age,disease duration,BMI,blood pressure and biochemical indicators were also recorded. Results MUA group MAGE was significantly higher than that of NUA group,the difference was statistically significant (P<0.05). MAGE with age,duration,Scr,UACR was moderately correlated,and systolic pressure,diastolic blood pressure,BMI,ALT are low.Conclusion Urinary albumin excretion increase is related to the blood sugar fluctuation in type 2 diabetics with targeted HbA1c.