摘要
目的:探讨引起糖尿病患者血糖波动及并发症发生的风险因素.方法:纳入238名确诊并行规范化诊疗和随访的2型糖尿病患者为研究对象,根据是否发生血糖波动及是否发生糖尿病并发症将其分为血糖波动组(n=54)和无血糖波动组(n=184);糖尿病并发症组(n=35)、无糖尿病并发症组(n=203).通过12个月的随访,分别经单因素及多因素回归分析明确引起糖尿病患者血糖波动及并发症发生的风险因素,并建立风险预测模型.结果:单因素、多因素分析显示,男性、吸烟、病程越长、治疗线数、血甘油三酯(TG)水平越高是引起患者血糖波动的独立风险因素(P＜0.05);年龄、男性、吸烟、病程越长、治疗线数、糖化血红蛋白、TG越高、肾小球滤过率(eGFR)水平越低是引起患者糖尿病并发症发生的独立风险因素(P＜0.05).基于风险因素最终建立起糖尿病患者血糖波动和糖尿病患者并发症发生的风险预测模型,通过内部验证绘制ROC曲线,计算曲线下面积分别为0.954和0.934,证明模型的预测效能较好.结论:男性、吸烟、病程、治疗线数、TG水平越高是引起患者血糖波动的独立风险因素.年龄、男性、吸烟、病程、治疗线数、糖化血红蛋白、TG越高、eGFR水平越低是引起患者糖尿病并发症发生的独立风险因素.基于风险因素最终可以建立起糖尿病患者血糖波动、糖尿病患者并发症发生的风险预测模型,且该模型的预测效能较好.
Abstract
Objective:To explore the risk factors of blood glucose fluctuation and complications in patients with diabetes.Meth-ods:23 8 patients with type 2 diabetes were retrospectively selected for standardized diagnosis,treatment and follow-up.According to whether the diabetic patients had blood glucose fluctuation and diabetic complications,they were divided into blood glucose fluctuation group(n=54),non-blood glucose fluctuation group(n=184),and diabetic complication group(n=35),non-diabetic complication group(n=203).After 12-month follow-up,the risk factors of blood glucose fluctuation and complications in patients with diabetes were identified by univariate analysis and multivariate regression analysis.And establish a risk prediction model for the occurrence of blood glucose fluctuation and diabetes in patients with diabetes.Results:Univariate and multivariate regression analysis showed that male,smoking,course of disease,number of treatment lines,and higher levels of blood triglycerides(TG)were independent risk factors for causing blood glucose fluctuations in patients(P＜0.05).Age,male,smoking,course of disease,number of treatment lines,glycosylat-ed hemoglobin,higher TG and lower level of glomerular filtration rate(eGFR)were independent risk factors for diabetic complications(P＜0.05).Based on the risk factors,the risk prediction model of blood glucose fluctuation and diabetic complications in patients with diabetes were established.Through internal verification,the area under the curve calculated by ROC curve was 0.954 and 0.934,which proved that the prediction efficiency of the model was better.Conclusion:Male,smoking history,course of disease,number of treatment lines and TG level are independent risk factors for blood glucose fluctuation in patients.Age,male,smoking,course of disease,number of treatment lines,glycosylated hemoglobin,higher TG and lower eGFR levels are independent risk factors for diabetic complications.Based on the risk factors,the risk prediction model of blood glucose fluctuation and complications in patients with diabetes can be estab-lished,and the prediction efficiency of the model is good.
维普
万方数据