邓明群;周丽媛;翟笑;刘洁颖;付俊玲;虞睿琪;潘妘頔;马丽媛;于淼;许建萍;李文慧;冯凯;肖新华;
DENG Mingqun;ZHOU Liyuan;ZHAI Xiao;LIU Jieying;FU Junling;YU Ruiqi;PAN Yundi;MA Liyuan;YU Miao;XU Jianping;LI Wenhui;FENG Kai;XIAO Xinhua;Department of Endocrinology,Key Laboratory of Endocrinology,National Health Commission of the People' s Republic of China,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College;

• 1:中国医学科学院北京协和医学院北京协和医院内分泌科卫健委内分泌重点实验室

摘要(Abstract)：

目的分析中国成人1型糖尿病(type 1 diabetes mellitus, T1DM)患者扫描式葡萄糖监测系统(flash glucose monitoring system, FGMS)衍生的目标范围时间(time in range, TIR)与糖化血红蛋白(glycated hemoglobin, HbA1c)的关系。方法前瞻性收集并分析2018年10月至2019年3月北京协和医院内分泌科门诊招募的成人T1DM患者的临床资料。患者均测定HbA1c,并佩戴医院版FGMS 14 d,计算TIR以及葡萄糖变异系数(coefficient of variation, CV)等指标。采用Spearman法分析TIR与HbA1c的相关性,采用简单线性回归法分析TIR与HbA1c的关系。结果共77例符合纳入和排除标准的T1DM患者纳入分析,HbA1c为(7.5±1.3)%,TIR为62.0(48.7,67.8)%,CV为(39.7±8.1)%。Spearman相关性分析显示,HbA1c与TIR呈负相关(r=-0.645,P<0.001);线性回归方程为:HbA1c=10.58-0.05×TIR,TIR每增加10%,HbA1c下降0.5%。分层分析结果显示,血糖稳定(CV<36%)/血糖不稳定(CV≥36%)患者的HbA1c与TIR均呈负相关(r=-0.774,P<0.001;r=-0.560,P<0.001),且在血糖稳定的患者中二者相关性更强。对于同一TIR,血糖稳定者的HbA1c较血糖不稳定者更高。结论在中国成人T1DM患者中,FGMS衍生的TIR与HbA1c呈负相关,可用于指导血糖管理,但TIR与HbA1c的相关性可能受血糖变异性影响。
Objective To explore the relationship between HbA1 c and time in range(TIR) derived from flash glucose monitoring system(FGMS) in Chinese adults with type 1 diabetes mellitus(T1 DM). MethodsAdult T1 DM patients attended the outpatient department of Peking Union Medical College Hospital(PUMCH) from October 2018 to March 2019 were included. HbA1 c and data of FGMS were obtained at the same time. TIR was calculated, and the relationship between TIR and HbA1 c was investigated by Spearman correlation andregression analysis. Results A total of 77 patients who met the inclusion and exclusion criteria were included in the analysis. The average HbA1 c was(7.5±1.3)%;TIR was 62.0(48.7,67.8)% and coefficient of variation(CV) was(39.7±8.1)%. TIR derived from FGMS had a negative liner correlation with HbA1 c(r=-0.645, P<0.001). The regression equation is: HbA1 c=10.58-0.05×TIR. The HbA1 c level is decreased by 0.5% for every 10% increase in TIR. TIR was negatively correlated with HbA1 c in patients with both stable glucose(CV<36%) and unstable glucose(CV≥36%), but the correlation coefficient between TIR and HbA1 c in patients with stable glucose was higher. For a specific TIR, HbA1 c was higher in patients with stable glucose. Conclusion The FGMS-derived TIR could be helpful in the glucose management in Chinese adults with T1 DM, and glucose variability should be taken into consideration while interpreting the relationship between TIR and HbA1 c.

关键词(KeyWords)： 1型糖尿病;扫描式葡萄糖监测系统;目标范围时间
type 1 diabetes mellitus;flash glucose monitoring system;time in range

Abstract:

Keywords:

基金项目(Foundation): 国家重点研发计划(2017YFC1309603)~~

作者(Authors): 邓明群;周丽媛;翟笑;刘洁颖;付俊玲;虞睿琪;潘妘頔;马丽媛;于淼;许建萍;李文慧;冯凯;肖新华;
DENG Mingqun;ZHOU Liyuan;ZHAI Xiao;LIU Jieying;FU Junling;YU Ruiqi;PAN Yundi;MA Liyuan;YU Miao;XU Jianping;LI Wenhui;FENG Kai;XIAO Xinhua;Department of Endocrinology,Key Laboratory of Endocrinology,National Health Commission of the People' s Republic of China,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College;

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