2型糖尿病合并下肢血管病变患者血糖波动与超敏C反应蛋白的相关性研究

摘要

Objective To investigate the relationship between the blood sugar fluctuations with high sensitivity C reactive protein (hs-CRP) in type 2 diabetes patients (T2DM) with deep lower extremity vascular diseases (DLEAD). Methods A total of 60 patients with T2DM during April 2013 and January 2014 in Department of Endocrinology were di-vided into patients with T2DM group (group A, n=30) and patients with T2DM complicated with lower extremity vascu-lar diseases group (group B, n=30). The levels of hs-CRP in the two groups were detected respectively; blood sugar monitoring was also performed by continuous glucose monitoring system ( CGMS) for 72 h in the two groups, and the val-ues of mean amplitude of glycemic excursions ( MAGE ) and standard deviation of blood glucose ( SDBG ) in the two groups were compared;the relationship between the clinical biochemical indexes and blood sugar parameters with hs-CRP level was analyzed. Results The levels of MAGE, SDBG and hs-CRP in group B were significantly higher than those in group A (P<0. 05). The levels of HbA1c, SDBG and MAGE was positively related to hs-CRP level ( r =0. 494, 0. 333, 0. 57, P<0. 05); the levels of SDBG and HbA1c was independently related to hs-CRP level ( Y=1. 923 +0. 622HbA1c+0. 961SDBG). Conclusion Blood sugar fluctuations is closely related to hs-CRP level in T2DM patients with DLEAD, and it may cause or aggravate diabetic lower extremity vascular disease by inducing inflammatory reaction in vivo.%目的：探讨2型糖尿病( T2DM)合并下肢血管病变( diabetic lower extremity arterial disease, DLEAD)患者血糖波动与超敏C反应蛋白( high sensitivity C reactive protein, hs-CRP)的相关性。方法选择2013年4月-2014年1月就诊于北京军区总医院内分泌科的T2DM 60例,分为单纯T2DM组(T2DM组)与合并DLEAD组(DLEAD组),每组30例。检测两组hs-CRP；应用动态血糖监测系统( monitored continuous glucose monitoring system, CGMS)行连续72 h血糖监测,比较两组日内平均血糖波动幅度( mean amplitude of glycemic excursions, MAGE)与全天血糖标准差( standard deviation of blood glucose, SDBG)；分析hs-CRP与血糖波动参数及临床生化指标的相关性。结果 DLEAD组MAGE、SDBG、hs-CRP比T2DM 组均明显升高(P <0.05)。 HbA1c、SDBG、MAGE 与 hs-CRP 呈显著正相关(r =0.494、0.333、0.57, P<0.05),SDBG、HbA1c与hs-CRP呈独立相关(Y=1.923+0.622HbA1c+0.961SDBG)。结论T2DM合并DLEAD患者的血糖波动与hs-CRP密切相关,可能通过诱发体内炎症反应引起DLEAD的发生、发展。