中华老年医学杂志
中華老年醫學雜誌
중화노년의학잡지
Chinese Journal of Geriatrics
2011年
7期
569-573
,共5页
陈素芳%李华%李天艺%焦文君%陈英伟%岳欣阁%李伟芳%冯明%杨再刚%赵艳艳%田勇
陳素芳%李華%李天藝%焦文君%陳英偉%嶽訢閣%李偉芳%馮明%楊再剛%趙豔豔%田勇
진소방%리화%리천예%초문군%진영위%악흔각%리위방%풍명%양재강%조염염%전용
糖尿病,2型%监测,生理学%血糖
糖尿病,2型%鑑測,生理學%血糖
당뇨병,2형%감측,생이학%혈당
Diabetes mellitus,type 2%Monitoring,physiologic%Blood glucose
目的 探讨老年2型糖尿病患者的动态血糖波动特点.方法 对老年2型糖尿病患者(老年组)92例和中青年2型糖尿病患者(中青年组)58例进行动态血糖监测,对比分析两组患者血糖谱特征及老年不同糖化血红蛋白(HbA1c)水平糖尿病患者的血糖谱特征.结果 (1)老年组与中青年组比较,血糖波动系数(BGFC)增大[(2.68±1.00)mmol/L对(2.12±0.74) mmol/L,t=-3.691,P＜0.001];餐后血糖漂移幅度(PPGE)增大,早餐后分别为 ( 5.96±2.47) mmol/L对(5.11±2.44) mmol/L(t=-2.058,P＜0.05),晚餐后分别为(5.17±2.15) mmol/L对 (4.16±2.28) mmol/L(t=-2.730,P＜0.01);餐后血糖达峰时间延长,早餐后(112.5±29.7) min对(97.0±27.2) min(t=-3.225,P＜0.01),中餐后(140.0±39.7)min对 (118.1±42.6) min(t=-3.195,P＜0.01);低血糖发生频率增加(26.3%对5.5%,P＜0.05);最大血糖漂移幅度(LAGE)增大,分别为(9.66±2.48) mmol/L对(8.40±3.13) mmol/L(t=-2.720,P＜0.01);(2)老年组患者随HbA1c下降,低血糖发生率增加(P＜0.05);随 HbA1c升高,血糖波动幅度增大;(3)HbA1c与空腹血糖(FBG)、日平均血糖(MBG)、高血糖时间比(PT7.8、PT11.1)、最低血糖(LBG)、最高血糖(HBG)、BGFC、PPGE、LAGE均正相关(r=0.899～0.289,均P＜0.001);逐步回归分析显示,MBG、FBG、PT7.8与HbA1c独立相关(校正的R2=0.807,P＜0.05).结论 老年2型糖尿病患者血糖波动幅度大,易发生餐后高血糖和夜间低血糖,动态血糖监测能较详细地显示患者的血糖水平及波动特征.
目的 探討老年2型糖尿病患者的動態血糖波動特點.方法 對老年2型糖尿病患者(老年組)92例和中青年2型糖尿病患者(中青年組)58例進行動態血糖鑑測,對比分析兩組患者血糖譜特徵及老年不同糖化血紅蛋白(HbA1c)水平糖尿病患者的血糖譜特徵.結果 (1)老年組與中青年組比較,血糖波動繫數(BGFC)增大[(2.68±1.00)mmol/L對(2.12±0.74) mmol/L,t=-3.691,P＜0.001];餐後血糖漂移幅度(PPGE)增大,早餐後分彆為 ( 5.96±2.47) mmol/L對(5.11±2.44) mmol/L(t=-2.058,P＜0.05),晚餐後分彆為(5.17±2.15) mmol/L對 (4.16±2.28) mmol/L(t=-2.730,P＜0.01);餐後血糖達峰時間延長,早餐後(112.5±29.7) min對(97.0±27.2) min(t=-3.225,P＜0.01),中餐後(140.0±39.7)min對 (118.1±42.6) min(t=-3.195,P＜0.01);低血糖髮生頻率增加(26.3%對5.5%,P＜0.05);最大血糖漂移幅度(LAGE)增大,分彆為(9.66±2.48) mmol/L對(8.40±3.13) mmol/L(t=-2.720,P＜0.01);(2)老年組患者隨HbA1c下降,低血糖髮生率增加(P＜0.05);隨 HbA1c升高,血糖波動幅度增大;(3)HbA1c與空腹血糖(FBG)、日平均血糖(MBG)、高血糖時間比(PT7.8、PT11.1)、最低血糖(LBG)、最高血糖(HBG)、BGFC、PPGE、LAGE均正相關(r=0.899～0.289,均P＜0.001);逐步迴歸分析顯示,MBG、FBG、PT7.8與HbA1c獨立相關(校正的R2=0.807,P＜0.05).結論 老年2型糖尿病患者血糖波動幅度大,易髮生餐後高血糖和夜間低血糖,動態血糖鑑測能較詳細地顯示患者的血糖水平及波動特徵.
목적 탐토노년2형당뇨병환자적동태혈당파동특점.방법 대노년2형당뇨병환자(노년조)92례화중청년2형당뇨병환자(중청년조)58례진행동태혈당감측,대비분석량조환자혈당보특정급노년불동당화혈홍단백(HbA1c)수평당뇨병환자적혈당보특정.결과 (1)노년조여중청년조비교,혈당파동계수(BGFC)증대[(2.68±1.00)mmol/L대(2.12±0.74) mmol/L,t=-3.691,P＜0.001];찬후혈당표이폭도(PPGE)증대,조찬후분별위 ( 5.96±2.47) mmol/L대(5.11±2.44) mmol/L(t=-2.058,P＜0.05),만찬후분별위(5.17±2.15) mmol/L대 (4.16±2.28) mmol/L(t=-2.730,P＜0.01);찬후혈당체봉시간연장,조찬후(112.5±29.7) min대(97.0±27.2) min(t=-3.225,P＜0.01),중찬후(140.0±39.7)min대 (118.1±42.6) min(t=-3.195,P＜0.01);저혈당발생빈솔증가(26.3%대5.5%,P＜0.05);최대혈당표이폭도(LAGE)증대,분별위(9.66±2.48) mmol/L대(8.40±3.13) mmol/L(t=-2.720,P＜0.01);(2)노년조환자수HbA1c하강,저혈당발생솔증가(P＜0.05);수 HbA1c승고,혈당파동폭도증대;(3)HbA1c여공복혈당(FBG)、일평균혈당(MBG)、고혈당시간비(PT7.8、PT11.1)、최저혈당(LBG)、최고혈당(HBG)、BGFC、PPGE、LAGE균정상관(r=0.899～0.289,균P＜0.001);축보회귀분석현시,MBG、FBG、PT7.8여HbA1c독립상관(교정적R2=0.807,P＜0.05).결론 노년2형당뇨병환자혈당파동폭도대,역발생찬후고혈당화야간저혈당,동태혈당감측능교상세지현시환자적혈당수평급파동특정.
Objective To investigate the characteristics of the blood glucose fluctuation in elderly patients with type 2 diabetes mellitus (T2DM). Methods The 92 elderly patients with T2DM (the elderly group) and 58 young and middle-aged patients with T2DM (the non-elderly group) were monitored using the continuous glucose monitoring system(CGMS). The characteristics of glucose profiles of the two different age groups, and of the different glycosylated hemoglobin (HbA1c) level groups in the elderly were comparatively analyzed. Results (1)There was no significant difference in HbA1c level between the elderly group and the non-elderly group. Compared with the non-elderly group, the elderly group showed the increases in blood glucose fluctuant coefficient [BGFC, (2.68±1.00) mmol/L vs. (2.12±0.74) mmol/L, t=-3.691, P＜0.001], in postprandial glucose excursion (PPGE) of breakfast and supper [(5.96±2.47) mmol/L vs. (5.11±2.44) mmol/L, t=-2.058, P＜0.05; (5.17±2.15) mmol/L vs. (4.16±2.28) mmol/L, t=-2.730, P＜0.01], in the time to postprandial glucose peak of breakfast and lunch [(112.5±29.7) min vs. (97.0±27.2) min, t=-3.225, P＜0.01; (140.0±39.7) min vs. (118.1±42.6) min, t=-3.195, P＜0.01], in the frequency of hypoglycemia (26.3% vs. 5.5%, P＜0.05), and showed the largest amplitude of glycemic excursions [LAGE, (9.66±2.48) mmol/L vs.(8.40±3.13) mmol/L, t=-2.720, P＜0.01]. (2)In the elderly, along with decreased HbA1c, the incidence of hypoglycaemia increased (P＜0.05); And along with increased HbA1c, the amplitude of blood glucose fluctuation increased. There were significant differences in BGFC, PPGE of breakfast and lunch, and LAGE among different HbA1c level groups (P＜0.01, P＜0.05, P＜0.05, P＜0.001). (3)HbA1c was positively correlated with FBG, mean blood glucose (MBG), percentage of time at glycemia (PT7.8, PT11.1), the lowest blood glucose (LBG), the highest blood glucose (HBG), BGFC, PPGE and LAGE (r=0.899-0.289, all P＜0.001). Multiple stepwise regression analysis indicated that MBG, FBG and PT7.8 was the independent influential factor of HbA1c (adjusted R2=0.807, P＜0.05). Conclusions The elderly patients with T2DM are at a particularly high risk for postprandial hyperglycemia and nocturnal hypoglycemic episodes, CGMS could show glucose fluctuation characters of T2DM patients diurnally, and provide a clinical basis for reasonable therapy.
