文章摘要
许 琳,钟 绍,潘 颖,方玲娜,卢 冰,唐 伟,高 远,许 岚,姚丽君,武晓泓.住院糖尿病患者空腹高血糖及其相关因素的分析——一项多中心的临床调查研究[J].南京医科大学学报,2015,(12):1722~1726
住院糖尿病患者空腹高血糖及其相关因素的分析——一项多中心的临床调查研究
Analysis of fasting hyperglycemia and its related factors in hospitalized patients with diabetes——a multicenter clinical study
投稿时间:2015-07-17  
DOI:10.7655/NYDXBNS20151211
中文关键词: 空腹高血糖  黎明现象  全天血糖控制不佳  Somogyi效应
英文关键词: fasting hyperglycemia  dawn phenomenon  poor glucose control throughout the day  Somogyi effect
基金项目:国家自然科学基金项目(81261120566);江苏省医学重点人才项目(RC2011068);江苏省“六大人才高峰”项目(苏人社发[2011]582号)
作者单位
许 琳 南京医科大学第一附属医院内分泌科,江苏 南京 210029 
钟 绍 昆山市第一人民医院内分泌科,江苏 昆山 215335 
潘 颖 昆山市第一人民医院内分泌科,江苏 昆山 215335 
方玲娜 昆山市第一人民医院内分泌科,江苏 昆山 215335 
卢 冰 昆山市第一人民医院内分泌科,江苏 昆山 215335 
唐 伟 江阴市人民医院内分泌科,江苏 江阴 214400 
高 远 江阴市人民医院内分泌科,江苏 江阴 214400 
许 岚 南京医科大学附属无锡人民医院内分泌科,江苏 无锡 214023 
姚丽君 南京医科大学附属无锡人民医院内分泌科,江苏 无锡 214023 
武晓泓 南京医科大学第一附属医院内分泌科,江苏 南京 210029 
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中文摘要:
      目的:观察住院糖尿病患者中空腹高血糖的状况并分析其相关因素。方法:选取2013年1月—2014年12月在5家医院行动态血糖监测?资料完整的住院糖尿病患者1 055例。收集性别?年龄?糖尿病分型?病程?体重指数(BMI)?血压?糖化血红蛋白(HbA1c)?血脂?尿白蛋白?大血管病变等临床资料,分析相关因素。结果:在住院糖尿病患者中,83.9%存在空腹高血糖,其中全天血糖控制不佳占75.2%,黎明现象占15.4%,Somogyi效应占9.4%。1型糖尿病患者Somogyi效应发生率显著高于2型,2型糖尿病患者全天不佳发生率显著高于1型。单因素分析结果显示在3个亚组中年龄?分型?病程?血压?血脂具有差异性(P < 0.05)。二分类Logistic分析结果显示年龄越大?病程越长?甘油三酯(TG)和低密度脂蛋白胆固醇(LDL-C)越高,全天血糖控制不佳发生的风险越大(P < 0.05),年龄越小?病程越短?收缩压越高?总胆固醇(TC)越高,黎明现象发生的风险越大(P < 0.05),TC?TG越低,Somogyi效应发生的风险越大(P < 0.05)。结论:住院糖尿病患者中普遍存在空腹高血糖现象,原因依次为全天血糖控制不佳?黎明现象?Somogyi效应。1型糖尿病更容易发生Somogyi效应。年龄?病程?TG?LDL-C为全天血糖控制不佳的危险因素,年龄?病程?收缩压?TC为黎明现象的危险因素,TC?TG为Somogyi效应的危险因素。
英文摘要:
      Objective:To investigate the status and related factors of fasting hyperglycemia in hospitalized patients with diabetes. Methods:Total 1055 diabetic patients who underwent continuous glucose monitoring from Jan.2013 to Dec. 2014 in five hospitals were enrolled in this study. Sex,age,type of diabetes,duration,body mass index(BMI),blood pressure,glycosylated hemoglobin (HbA1c),blood lipid,urinary albumin,macroangiopathy and so on were collected to analyze the risk factors. Results:Totally 83.9% of diabetic patients had fasting hyperglycemia,of which 75.2% was poor glucose control throughout the day,15.4% was dawn phenomenon and 9.4% was Somogyi effect. The incidence of Somogyi effect in type 1 diabetes patients was significantly higher than that in type 2,and the incidence of poor glucose control throughout the day in type 2 diabetes patients was significantly higher than that of type 1. The one-way ANOVA analysis results showed that there were significantly differences of age,type,duration,blood pressure,blood lipid between dawn phenomenon group,Somogyi effect group,and poor glucose control throughout the day group (P < 0.05). The binary logistic regression analysis results showed that older,longer duration,higher TG,and higher LDL-C were more likely to occur in poor glucose control throughout the day (P < 0.05). Patients with younger age,shorter duration,higher systolic blood pressure or higher TC were more likely to have dawn phenomenon (P < 0.05). Lower TC and TG were more prone to Somogyi effect (P < 0.05). Conclusion:Fasting hyperglycemia was a common phenomenon among hospitalized patients with diabetes. The causes in sequence were poor glucose control,dawn phenomenon and Somogyi effect. Type 1 diabetes patients were more likely to have Somogyi effect. Age,duration,TC,and LDL-C were risk factors for poor glucose control throughout the day; Age,duration,systolic blood pressure and TC were risk factors for dawn phenomenon; TC,TG were risk factors for Somogyi effect.
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