背景：目前尚不清楚血糖变异性是否与糖尿病微血管病变有关，尤其是糖尿病周围神经病变（DPN）。我们研究了血糖变异性和DPN与1型或2型糖尿病之间的关系。
方法：40例患者（男23例，女17例；年龄34-79岁）接受了连续血糖监测（CGM）和神经传导研究（NCS）。通过CGM中的平均血糖波动幅度(MAGE)来估计血糖变异性。DPN由NCS在中位数中进行定量评估，胫骨,腓肠和足底内侧神经。
结果：MAGE与病程和低密度脂蛋白胆固醇水平呈显著正相关（r=0.462，p=0.003；r=0.40，p=0.011），与BMI和足底内侧复合神经动作电位幅度呈显着负相关（分别为r=-0.39，p=0.012；和r=-0.32，p=0.042）。调整临床背景的多元线性回归分析显示，MAGE（β=-0.49，p=0.007）与足底内侧神经病的高风险独立相关。
结论：血糖变异性可能是DPN的独立危险因素。
BACKGROUND: It remains unclear whether glycemic variability is related to diabetes microvascular disease, especially diabetes peripheral neuropathy (DPN). We investigated the association between glycemic variability and DPN with type 1 or 2 diabetes.
METHODS: Forty patients (23 males and 17 females; aged 34-79 years) underwent continuous glucose monitoring (CGM) and a nerve conduction
study (NCS). Glycemic variability was estimated by mean amplitude of glycemic excursions (MAGE) in CGM. DPN was quantitatively evaluated by NCS in the median, tibial, sural and medial plantar nerves.
RESULTS: MAGE had a significantly positive correlation with disease duration and low-density lipoprotein cholesterol level (r = 0.462, p = 0.003; and r = 0.40, p = 0.011, respectively), and a significantly negative correlation with BMI and medial plantar compound nerve action potential amplitude (r = - 0.39, p = 0.012; and r = - 0.32, p = 0.042, respectively). Multivariate linear regression analysis with adjustment for clinical background showed that MAGE (β = - 0.49, p= 0.007) was independently associated with a higher risk of medial plantar neuropathy.
CONCLUSIONS: Glycemic variability may be an independent risk factor for DPN.
PDF(Pubmed)