Citation: | YIN Xiaorong, HU Xiujuan, WANG Shuqian, CUI Mengjie, HUANG Qinyi, YIN Yangliu, ZHANG Ya, SUN Yan. The correlation between the coefficient of variation of blood glucose and peripheral neuropathy in type 2 diabetes[J]. Journal of Clinical Medicine in Practice, 2023, 27(13): 48-52. DOI: 10.7619/jcmp.20231487 |
To explore the correlations of clinical data and glucose data collected by continuous glucose monitoring system (CGM) with diabetic peripheral neuropathy (DPN) in hospitalized type 2 diabetic patients(T2DM) and its risk prediction value.
The clinical data of 97 T2DM patients hospitalized in the Department the First Affiliated Hospital of Anhui Medical University were collected, and their blood glucose was recorded by CGM, and the mean blood glucose, coefficient of variation of blood glucose (CV), standard deviation of blood glucose (SD), mean 24-hour fluctuation of blood glucose (MAGE), mean absolute difference of day-to-day blood glucose (MODD) and time within normal target range for glucose (TIR). The enrolled patients were divided into non-DPN free (NDPN) group (n=49) and DPN group (n=48). Clinical data and CGM-related indicators were analyzed between the two groups, and the correlations between CGM-related indicators and the risk of DPN development were analyzed using binary Logistic regression analysis; the predictive value of CV for the development of DPN was analyzed using the receiver operating characteristic (ROC) curve.
The differences in age, systolic blood pressure and platelets (PLT) were found between the DPN group and the NDPN group (P < 0.05). The results of CGM correlation data analysis suggested statistically significant differences in CV, SD, MAGE and MODD between the two groups (P < 0.05). Binary Logistic regression analysis showed that higher CV was a risk factor for T2DM peripheral neuropathy (P < 0.05). The area under the ROC curve was 0.714 (95%CI, 0.613 to 0.814, P < 0.001), with a cut-off value of 45.80%, the sensitivity was 66.70% and the specificity was 65.30%.
There are significant differences in age, systolic pressure, PLT, CV, SD, MAGE and MODD between the two groups; CV is a influencing factor for the development of DPN, and has a good predictive value for the development of DPN.
[1] |
段丽君, 王健, 韩静, 等. 天津市2型糖尿病慢性并发症流行病学研究[J]. 重庆医学, 2019, 48(22): 3874-3878. doi: 10.3969/j.issn.1671-8348.2019.22.023
|
[2] |
杨晓晖, 白颖. 糖尿病性周围神经病变的诊断和处理[J]. 中华全科医学, 2017, 15(1): 5-6. https://www.cnki.com.cn/Article/CJFDTOTAL-SYQY201701002.htm
|
[3] |
SELAM J L. How to measure glycemic instability?[J]. Diabetes Metab, 2000, 26(2): 148-151.
|
[4] |
中华医学会糖尿病学分会. 中国2型糖尿病防治指南(2020年版)[J]. 中华糖尿病杂志, 2021, 13(4): 315-409. https://www.cnki.com.cn/Article/CJFDTOTAL-HBYX202112018.htm
|
[5] |
雷远, 陶睿, 王佑民. 不同年龄层次糖尿病患者并发周围神经病变的危险因素比较[J]. 神经损伤与功能重建, 2020, 15(8): 453-456. doi: 10.16780/j.cnki.sjssgncj.20200132
|
[6] |
SHUN C T, CHANG Y C, WU H P, et al. Skin denervation in type 2 diabetes: correlations with diabetic duration and functional impairments[J]. Brain, 2004, 127(Pt 7): 1593-1605.
|
[7] |
赫广玉, 孙成林, 刘玉佳, 等. 糖尿病周围神经病变神经损害特点及相关因素分析[J]. 中国糖尿病杂志, 2014, 22(2): 118-121. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGTL201402008.htm
|
[8] |
赵军明, 陈蜀敏, 李伶俐, 等. 2型糖尿病周围神经病变与血小板平均体积的相关性分析[J]. 临床医学, 2015, 35(10): 11-12. https://www.cnki.com.cn/Article/CJFDTOTAL-EBED201510005.htm
|
[9] |
刘爱兰, 马利军, 赵恺, 等. 外周血白细胞计数对2型糖尿病并发周围神经病变的早期诊断价值[J]. 中国药物与临床, 2020, 20(15): 2514-2516. https://www.cnki.com.cn/Article/CJFDTOTAL-YWLC202015014.htm
|
[10] |
李利阳, 高松, 虎晓燕, 等. 血浆纤维蛋白原水平与2型糖尿病神经病变的关系[J]. 新疆医科大学学报, 2016, 39(9): 1159-1162. https://www.cnki.com.cn/Article/CJFDTOTAL-XJYY201609021.htm
|
[11] |
ZHANG Y Z, JIANG Y, SHEN X M, et al. Can both normal and mildly abnormal albuminuria and glomerular filtration rate be a danger signal for diabetic peripheral neuropathy in type 2 diabetes mellitus[J]. Neurol Sci, 2017, 38(8): 1381-1390.
|
[12] |
秦明, 宋玉玲, 张亭, 等. 中国人群2型糖尿病周围神经病变危险因素的系统评价[J]. 中国当代医药, 2021, 28(1): 20-26. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGUD202101005.htm
|
[13] |
姜涛, 宋秀霞, 张敏, 等. 波动性高血糖对2型糖尿病患者周围神经病变的影响[J]. 中国慢性病预防与控制, 2010, 18(1): 54-56. https://www.cnki.com.cn/Article/CJFDTOTAL-ZMXB201001023.htm
|
[14] |
FONSECA V A, GRUNBERGER G, ANHALT H, et al. Continuous glucose monitoring: a consensus conference of the American association of clinical endocrinologists and American college of endocrinology[J]. Endocr Pract, 2016, 22(8): 1008-1021.
|
[15] |
RODBARD D. Hypo- and hyperglycemia in relation to the mean, standard deviation, coefficient of variation, and nature of the glucose distribution[J]. Diabetes Technol Ther, 2012, 14(10): 868-876.
|
[16] |
MONNIER L, COLETTE C, WOJTUSCISZYN A, et al. Toward defining the threshold between low and high glucose variability in diabetes[J]. Diabetes Care, 2017, 40(7): 832-838.
|
[17] |
孙磊. 血糖变异性对糖尿病视网膜病变患者眼血流参数的影响研究[J]. 中国医学创新, 2021, 18(33): 141-145. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYCX202133036.htm
|
[18] |
SLIEKER R C, VAN DER HEIJDEN A A W H, NIJPELS G, et al. Visit-to-visit variability of glycemia and vascular complications: the Hoorn Diabetes Care System cohort[J]. Cardiovasc Diabetol, 2019, 18(1): 170.
|
[19] |
汪博, 李亚娟, 杜瑞妮, 等. 血糖变异系数对肾移植预后的预测价值[J]. 重庆医学, 2022, 51(3): 361-365. https://www.cnki.com.cn/Article/CJFDTOTAL-CQYX202203001.htm
|
[20] |
曾建琼, 程青虹, 王桂萍. 老年脓毒症患者血糖变异度与预后的相关性[J]. 中国老年学杂志, 2017, 37(10): 2520-2522. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLXZ201710083.htm
|
[21] |
SU J B, ZHAO L H, ZHANG X L, et al. HbA1c variability and diabetic peripheral neuropathy in type 2 diabetic patients[J]. Cardiovasc Diabetol, 2018, 17(1): 47.
|
[22] |
FIROUZABADI M D, POOPAK A, SHEIKHY A, et al. Glycemic profile variability: an independent risk factor for diabetic neuropathy in patients with type 2 diabetes[J]. Prim Care Diabetes, 2023, 17(1): 38-42.
|
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