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目的通过动态血糖监测系统分析单纯性肥胖患者的血糖变化特点。方法分别对21例一级亲属患有糖尿病的单纯性肥胖患者及正常非肥胖者进行OGTT、CGM、Hb A1c检测,分析并比较2组OGTT结果、Hb A1c水平及动态血糖监测各项参数,包括MBG、SDBG、MAGE、LAGE等。结果 21例肥胖患者的平均Hb A1c水平与正常体重者相比较,差异无统计学意义(P>0.05);OGTT结果显示,肥胖患者中有5例(23.8%)存在空腹血糖受损(IFG)(FBG≥5.6 mmol/L且<7.0 mmol/L),5例(23.8%)存在糖耐量减低(IGT)(2 h BG≥7.8 mmol/L且<11.1 mmol/L),没有确诊为糖尿病的患者。动态血糖监测(CGM)结果显示,肥胖组MBG与正常组相比差异无统计学意义(P>0.05),肥胖组SDBG、MAGE与LAGE均较正常组显著升高(P<0.01)。CGMS检测到7例(33.3%)血糖最大值≥11.1 mmol/L,5例(23.8%)餐后2 h血糖≥11.1 mmol/L,3例(14.3%)出现了低血糖(<3.0 mmol/L)。结论动态血糖监测系统(CGMS)能够较传统方法(如OGTT和Hb A1c)检测到更多的血糖异常,尤其对于有糖尿病家族史的肥胖患者,可通过CGMS尽早发现异常的血糖及血糖波动情况,并及时给予干预措施,减少糖尿病及其并发症的发生。
Objective To analyze the changes of blood glucose in simple obesity patients by using dynamic blood glucose monitoring system. Methods OGTT, CGM and Hb A1c were detected in 21 cases of first-degree relatives with simple obesity and non-obese subjects with diabetes. The parameters of OGTT, Hb A1c and dynamic glucose monitoring were compared and analyzed, including MBG, SDBG, MAGE, LAGE and so on. Results The mean Hb A1c level of 21 obese patients was not significantly different from that of normal weight (P> 0.05). OGTT showed that there were 5 cases (23.8%) of impaired fasting plasma glucose (IFG) (FBG≥5.6 mmol / L and <7.0 mmol / L), IGT (2 h BG≥7.8 mmol / L and <11.1 mmol / L) in 5 patients (23.8% patient. The results of dynamic glucose monitoring (CGM) showed that the obese group had no significant difference in MBG compared with normal group (P> 0.05). The levels of SDBG, MAGE and LAGE in obese group were significantly higher than those in normal group (P <0.01). CGMS detected blood glucose of ≥11.1 mmol / L in 7 patients (33.3%), blood glucose of ≥11.1 mmol / L in 5 patients (23.8%) at 2 h after meal, hypoglycemia in 3 patients (<3.0 mmol / L). Conclusion CGMS can detect more abnormal blood glucose than traditional methods (such as OGTT and Hb A1c). Especially for obese patients with a family history of diabetes, CGMS can detect abnormal blood glucose and blood glucose fluctuations as soon as possible, And timely interventions to reduce the incidence of diabetes and its complications.