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目的探讨血糖波动与早期糖尿病肾病脂联素的相关性。方法 30例应用诺和灵30R治疗的早期2型糖尿病肾病患者[糖化血红蛋白(Hb A1c)>7.5%]改用诺和锐30治疗12周,治疗前后进行连续72 h动态血糖监测,同时观测体质量指数(BMI)、空腹血糖(FBG)及餐后2 h血糖(2 h PG)、Hb A1c、总胆固醇(TC)、三酰甘油(TG)、脂联素(APN)、高敏C-反应蛋白(hs-CRP)、尿微量白蛋白(MA)及尿肌酐(UCr)等指标变化。结果经诺和锐30治疗后,BMI、FBG、TC和TG与治疗前比较无明显变化,Hb A1c较治疗前有所下降,但差异未见统计学意义(P>0.05);2 h PG、hs-CRP、尿微量白蛋白/肌酐比值(ACR)均明显下降(P均<0.05),APN明显升高(P<0.05);24 h平均血糖水平(24 h MBG)治疗前后比较差异未见统计学意义;日间平均血糖波动幅度(MAGE)、日间血糖平均绝对差(MODD)及餐后血糖波动幅度(PPGE)治疗后与治疗前比较均有不同程度的下降,差异有统计学意义(P均<0.05)。相关性分析显示,治疗后APN与2 h PG、Hb A1c、hs-CRP、ACR、MAGE及PPGE呈负相关。结论诺和锐30治疗能减轻血糖波动,可能通过增加糖尿病肾病APN水平对肾脏起保护作用。
Objective To investigate the correlation between blood glucose fluctuation and adiponectin in early diabetic nephropathy. Methods Thirty patients with early type 2 diabetic nephropathy (Hb A1c> 7.5%) treated with Novolin 30R were treated with Novo-Rui 30 for 12 weeks and monitored for continuous 72-hour dynamic glucose monitoring before and after treatment. Meanwhile, (BMI), fasting blood glucose (FBG) and postprandial 2h blood glucose (2h PG), Hb A1c, total cholesterol (TC), triglyceride (TG), adiponectin (APN) Protein (hs-CRP), urinary albumin (MA) and urinary creatinine (UCr) and other indicators changes. Results No significant changes were found in BMI, FBG, TC and TG after treatment with Nuo-Rui-Ru-30. Hb A1c was lower than before treatment, but the difference was not statistically significant (P> 0.05) hs-CRP and ACR decreased significantly (P <0.05), but APN increased significantly (P <0.05). There was no significant difference between 24 h MBG before and after treatment Statistical significance; Mean daily blood glucose fluctuation (MAGE), daytime blood glucose mean absolute difference (MODD) and postprandial blood glucose fluctuation range (PPGE) after treatment compared with before treatment decreased to some extent, the difference was statistically significant (P <0.05). Correlation analysis showed that APN was negatively correlated with 2 h PG, Hb A1c, hs-CRP, ACR, MAGE and PPGE after treatment. Conclusion Nuo-Rui-Rui 30 treatment can reduce blood glucose fluctuations, may increase the level of APN in diabetic nephropathy play a protective role on the kidney.