Association of glycemic variability assessed by continuous glucose monitoring with subclinical diabetic polyneuropathy in type 2 diabetes patients.
Association of glycemic variability assessed by continuous glucose monitoring with subclinical diabetic polyneuropathy in type 2 diabetes patients.
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通过连续葡萄糖监测与2型糖尿病患者中亚临床糖尿病多神经病的连续葡萄糖监测评估的血糖变异性的关联。
DOI：
10.1111/jdi.13652
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发表时间：
2022-03
影响因子：
3.2
通讯作者：
Wang C
中科院分区：
文献类型：
--
作者：
Pan J;Yan X;Li F;Zhang Y;Jiang L;Wang C
糖尿病周围神经病变是一种常见的糖尿病相关微血管并发症。周围神经功能与葡萄糖变异性之间的关系尚不清楚。我们在2型糖尿病患者的大规模样本中研究了葡萄糖变异性与亚临床糖尿病多发神经病变的关系。我们招募了509名2型糖尿病患者，他们接受了糖尿病周围神经病变筛查，并使用连续血糖监测系统进行监测。多个血糖变异性参数，包括血糖偏离的平均幅度，葡萄糖标准偏差（SDgluc）和葡萄糖变异系数，从连续血糖监测获得的3天血糖曲线计算。所有参与者都进行了神经传导研究，并计算了神经传导参数的综合Z -评分。多因素logistic回归分析显示，SDgluc与常规危险因素血红蛋白A1c （HbA1c）与神经功能异常独立相关，其比值比（95%可信区间）分别为1.198 （SDgluc 1.027 ~ 1.397）和1.182 （HbA1c 1.061 ~ 1.316）。神经传导速度和反应幅度的复合Z -评分随SDgluc的增加而明显降低，远端潜伏期的复合Z -评分随SDgluc的增加而显著升高（P趋势均<0.05）。在调整年龄、性别、体重指数、糖尿病病程和HbA1c后，SDgluc与神经传导速度独立相关（β = - 0.124, P = 0.021）。除了糖尿病病程和HbA1c等常规危险因素外，SDgluc是亚临床糖尿病多发神经病变的重要独立因素。我们进行了一项横断面研究，研究通过持续血糖监测评估的血糖变异性与2型糖尿病患者亚临床糖尿病多发神经病变的关系。我们的研究发现，血糖变异性的增加表现为葡萄糖标准偏差，是亚临床糖尿病多发神经病变的重要独立因素。
Diabetic peripheral neuropathy is a common diabetes‐related microvascular complication. The relationship between peripheral nerve function and glucose variability is unclear. We investigated the association of glucose variability with subclinical diabetic polyneuropathy in a large‐scale sample of patients with type 2 diabetes. We enrolled 509 individuals with type 2 diabetes who were screened for diabetic peripheral neuropathy and monitored using a continuous glucose monitoring system. Multiple glycemic variability parameters, including the mean amplitude of glycemic excursions, glucose standard deviation (SDgluc) and glucose coefficient of variation were calculated from 3‐day glucose profiles obtained from continuous glucose monitoring. All participants underwent nerve conduction studies, and the composite Z‐scores for nerve conduction parameters were calculated. Multivariate logistic regression analyses showed that SDgluc and the conventional risk factor hemoglobin A1c (HbA1c) were independently associated with abnormal nerve function, and the corresponding odds ratios (95% confidence interval) were 1.198 (1.027–1.397, SDgluc) and 1.182 (1.061–1.316, HbA1c), respectively. The composite Z‐score of nerve conduction velocity and response amplitude obviously decreased with greater SDgluc, and the composite Z‐score of distal latency significantly increased with increasing tertiles of SDgluc (all P trend <0.05). After adjusting for age, sex, body mass index, diabetes duration and HbA1c, SDgluc was independently associated with nerve conduction velocity (β = −0.124, P = 0.021). The SDgluc is a significant independent contributor to subclinical diabetic polyneuropathy, in addition to conventional risk factors including diabetes duration and HbA1c. We carried out a cross‐sectional study to investigate the association of glycemic variability assessed by continuous glucose monitoring with subclinical diabetic polyneuropathy in type 2 diabetes patients. Our study found that increased glycemic variability shown as glucose standard deviation is a significant independent contributor to subclinical diabetic polyneuropathy.
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