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在2型糖尿病患者中,血糖变化的临床影响和药理考虑
Alanood A Howsawi1, Manal M Alem2
1Department of Pharmacology, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, PO Box 1982, Dammam, 31441, Saudi Arabia.
Scientific reports
|October 14, 2024
概括
血糖变化 (GV) 预测2型糖尿病患者的主要不良心血管事件 (MACE),禁食血糖变化 (FBS-CV) 是一个关键指标. 某些糖尿病药物与较低的GV有关,可能会影响心血管结果.
科学领域:
- 内分泌学 在内分泌学.
- 心脏病学 心脏病学
- 代谢综合征是代谢综合征的一种.
背景情况:
- 血糖变化 (GV) 是2型糖尿病 (DM) 的新兴预后标志物,独立于整体血糖控制.
- 评估GV对心血管事件和微血管并发症的长期预测价值对于患者管理至关重要.
研究的目的:
- 在2型糖尿病人群中,评估长期GV对主要不良心血管事件 (MACE) 和糖尿病微血管并发症 (DMC) 的预后意义.
- 调查GV与各种抗糖尿病药物之间的关系.
主要方法:
- 对680名2型糖尿病患者 (2015-2017年) 的回顾性队列研究,平均随访时间为78.43个月.
- 使用标准偏差 (SD),变化系数 (CV) 和独立于平均值 (VIM) 的可变性来计算糖化血红蛋白 (G-Hb) 和禁食血糖 (FBS) 的GV.
- 考克斯比例危险模型和克鲁斯卡尔-瓦利斯试验用于对MACE和DMC预测进行统计分析.
主要成果:
- 长期GV独立预测MACE,禁食血糖变化系数 (FBS-CV) 显示出优于G-Hb的预测能力.
- 一个FBS-CV值≥17.51%显著预测了MACE (HR 1.589,P=0.040).
- 糖尿病微血管并发症 (DMC) 主要是由DM持续时间和血糖控制 (G-Hb,FBS) 预测的.
- 与接受胰岛素/硫尿素 (P<0.001) 治疗的患者相比,接受甲胺或二乙酶 (DPP) - 4抑制剂的患者表现出较低的GV (P<0.001).
结论:
- 长期的血糖变化,特别是FBS-CV,是2型糖尿病患者MACE的独立预测因子.
- 谷歌维生素与抗糖尿病药物的相关性表明,它们对心血管保护作用的潜在机制.
- 像G-Hb和FBS这样的血糖控制标志物是DMC的关键预测因素,而GV对宏血管风险更相关.
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