Laura B Bovee, Theodore A Gooley, Jordan E Perlman, Irl B Hirsch
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引用次数: 0
摘要
背景:以往的研究利用糖化指标评估了HbA1c不一致与糖尿病并发症之间的关系。理想的指标将允许识别那些微血管并发症的风险增加。本分析评估了一个新发表的指数,糖基化比率(GR)与糖尿病视网膜病变(DR)和糖尿病肾病(DKD)之间的关系。方法:对华盛顿大学661例糖尿病患者进行回顾性分析。所有患者在研究前均使用连续血糖监测(CGM)。糖尿病病程超过20年的占59%。中位年龄为45岁。GR定义为血糖管理指标(GMI)与HbA1c之比。采用logistic回归评估GR与微血管并发症的关系。结果:将GR建模为一个连续的线性变量,GR每增加0.20个单位,DR的几率相对降低38%(调整后的优势比[OR] = 0.62;95%可信区间[CI]: 0.45-0.86, P = 0.004], DKD的几率也有类似的降低(OR = 0.61;95% ci: 0.41-0.93, p = 0.02)。结论:GR可作为糖尿病微血管并发症风险的有效指标。将需要进行纵向评估,以了解GR与GMI或单独HbA1c相比有多好。
The Role of a Continuous Glucose Monitoring-Derived Glycation Ratio in the Development of Microvascular Complications.
Background: Previous studies have evaluated the associations between HbA1c discordance and diabetes complications using indices of glycation. The ideal index would allow for identification of those at increased risk for microvascular complications. This analysis evaluates the association of a newly published index, the glycation ratio (GR), with diabetic retinopathy (DR) and diabetic kidney disease (DKD). Methods: This is a retrospective review of 661 patients with diabetes seen at the University of Washington. All patients used continuous glucose monitoring (CGM) before the study. Diabetes duration was greater than 20 years in 59%. Median age was 45 years. GR was defined as the ratio of the glucose management indicator (GMI) to the HbA1c. The associations of GR with microvascular complications were each assessed using logistic regression. Results: Modeling GR as a continuous linear variable, each increase in GR of 0.20 units was associated with a 38% relative reduction in the odds of DR (adjusted odds ratio [OR] = 0.62; 95% confidence interval [CI]: 0.45-0.86, P = 0.004] and a similar reduction in the odds of DKD (OR = 0.61; 95% CI: 0.41-0.93, P = 0.02). Conclusions: GR may be a useful marker for risk of diabetic microvascular complications. Longitudinal assessment will be required to see how well GR compares with GMI or HbA1c alone.
期刊介绍:
Diabetes Technology & Therapeutics is the only peer-reviewed journal providing healthcare professionals with information on new devices, drugs, drug delivery systems, and software for managing patients with diabetes. This leading international journal delivers practical information and comprehensive coverage of cutting-edge technologies and therapeutics in the field, and each issue highlights new pharmacological and device developments to optimize patient care.