应用持续血糖监测系统评估2型糖尿病患者一级亲属的糖代谢特征

目的 用持续血糖监测系统(CGMS)评估口服葡萄糖耐量正常人群及2型糖尿病患者一级亲属的血糖稳定性.方法 用CGMS对50例受试者进行48～72 h的血糖监测,其中2型糖尿病患者一级亲属(FDR)22名,尤糖尿病家族史的正常糖调节人群(对照组)28名,比较CGMS监测中连续48 h的平均血糖水平(MBG)及其血糖水平标准差(SDBG)、日内平均血糖波动幅度(MAGE)及日间血糖平均绝对差等指标.用稳态模型评估法评估胰岛β细胞功能和胰岛素抵抗性(HOMA-IR),计算胰岛素分泌指数(△I30/△G30),修正的β细胞功能指数(MBCI)等指标.结果 FDR组的MAGE明显高于对照组[(2.3±0.5)mmol/L比(2.0±0.6)mmol/L,P<0.05)],MBCI在FDR组明显低于对照组[17.6(16.9～50.0)比36.0(15.7～59.6),P<0.05],其余指标在两组间差异无统计学意义.结论 CGMS监测剑2型糖尿病患者的FDR的血糖波动性较大,主要表现为MAGE增大.

Characteristics of glycometabolism in the first-degree relatives of type 2 diabetes patients assessed by continuous glucose monitoring system

Objective To investigate the characteristics of glycemic stability in the first-degree relatives of type 2 diabetes mellitus (T2DM) patients by continuous glucose monitoring system (CGMS). Methods Twenty-two first-degree relatives (FDRs) of T2DM patients and 28 age and gender-matched controls underwent CGMS to obtain the mean blood glucose (MBG) , standard deviation of MBG (SDBG), mean of daily differences (MODD), and mean amplitude of glycemic excursions (MAGE). Oral glucose tolerance test (OGTT) was conducted. Blood glucose, serum lipids, and serum insulin were assayed. The insulin sensitivity and resistance was assessed by HOMA-β, HOMA-IR, △I30/△G30 and modified β cell function index (MBCI). Results There were no significant differences between the FDR and control groups in the levels of plasma glucose in OGTT, MBG, SDBG, and MOOD. However, the MAGE level of the FDR group was (2.3±0.5) mmol/L, significantly higher than that of the control group [(2.0±0.6) mmol/L, P<0.05]. The MBCI level of the FDR group was 17.6 (16.9-50.0), significantly lower than that of the control group [36.0 (15.7-59.6), P<0.05]. There were no significant differences in the serum lipids profile, body fat distribution, HOMA-β, HOMA-IR, and △I30/△G30 between these two groups. Conclusion The excursion of blood glucose is greater in the FDRs of T2DM patients. CGMS is more sensitive to discover such change than OGTT.