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400042 重庆,陆军军医大学(第三军医大学)大坪医院高血压内分泌科,全军高血压代谢病中心,重庆市高血压研究所
[闫振成,E-mail:zhenchengyan@sina.com YAN Zhencheng, E-mail: zhenchengyan@sina.com
收稿:2021-05-13,
修回:2021-08-10,
纸质出版:2021-11-15
移动端阅览
刘肖肖, 李强, 何洪波, 等. 通过口服葡萄糖耐量试验估算平均血糖的数学模型[J]. 第三军医大学学报, 2021,43(21):2389-2394.
Xiaoxiao LIU, Qiang LI, Hongbo HE, et al. A mathematical model to estimate mean blood glucose by oral glucose tolerance test[J]. Journal of Third Military Medical University, 2021, 43(21): 2389-2394.
刘肖肖, 李强, 何洪波, 等. 通过口服葡萄糖耐量试验估算平均血糖的数学模型[J]. 第三军医大学学报, 2021,43(21):2389-2394. DOI: 10.16016/j.1000-5404.2021005049.
Xiaoxiao LIU, Qiang LI, Hongbo HE, et al. A mathematical model to estimate mean blood glucose by oral glucose tolerance test[J]. Journal of Third Military Medical University, 2021, 43(21): 2389-2394. DOI: 10.16016/j.1000-5404.2021005049.
目的
2
建立利用口服葡萄糖耐量试验估算平均血糖的方法。
方法
2
回顾分析2014年1月至2017年12月于本科住院治疗的2型糖尿病患者36例,所有患者完善动态血糖监测及口服葡萄糖耐量试验(oral glucose tolerance test
OGTT),收集患者人口学基本特征和实验室检查结果,建立数学模型并予以修正。根据拟合优度公式进行外部验证。
结果
2
纳入满足入组条件的糖尿病患者36例,应用OGTT试验估计全天平均血糖(
MBG
OGTT
)为(9.66±3.34)mmol/L,应用动态血糖监测仪计算24 h平均葡萄糖水平(24 hour mean glucose
24 h MBG)为(9.40±2.67)mmol/L。
MBG
OGTT
与糖化血红蛋白(HbA1c)(
r
=0.582,
P
<
0.001)、24 h MBG(
r
=0.674,
P
<
0.001)均呈显著正相关。应用线性回归模型建立OGTT估计的24 h动态血糖的模型:24 h
MBG
mmol
/
L
=4.166+0.545×
MBG
OGTT
(
R
=0.674,
P
<
0.001)。进一步将HbA1c纳入回归分析,得到修正模型:24 h
MBG
mmol
/
L
=1.797+0.359×
MBG
OGTT
+0.565×HbA1c(
R
=0.768,
P
<
0.001)。选取本科住院的患者18例进行外部验证,得到R
NL
=0.81,说明模型拟合优度较高。
结论
2
成功建立了一种应用OGTT试验评估全天平均血糖的模型,可作为评估糖尿病患者血糖谱变化的简易方法。
Objective
2
To establish a method for estimating mean blood glucose using oral glucose tolerance test (OGTT).
Methods
2
A retrospective study was conducted on the patients with type 2 diabetes mellitus (T2DM) in our department between January 2014 and December 2017. All the patients underwent continuous glucose monitoring (CGM) and OGTT. The basic demographic characteristics and results of laboratory tests of the patients were collected. Then relevant mathematical models were established and modified. In the end
external validation was carried out according to the goodness of fit formula.
Results
2
Thirty-six diabetic patients who met the enrollment criteria were recruited. The 24-hour mean blood glucose (24 h MBG) was estimated to be 9.66±3.34 mmol/L by OGTT (
MBG
OGTT
)
to be 9.40±2.67 mmol/L through CGM calculation.
MBG
OGTT
showed significa
ntly positive correlation with both glycosylated hemoglobin (HbA1c
r
=0.582
P
<
0.001) and 24 h MBG (
r
=0.674
P
<
0.001). We used linear regression model and established following equation to estimate 24 h MBG by OGTT: 24 h
MBG
mmol
/
L
=4.166+0.545×
MBG
OGTT
(
r
=0.674
P
<
0.001). Furthermore
a modified model incorporating HbA1c effect was also obtained: 24 h
MBG
mmol
/
L
=1.797+0.359×
MBG
OGTT
+0.565×HbA1c (
R
=0.768
P
<
0.001). We selected 18 patients admitted to our department for external validation. In this verification result
we obtained a R
NL
value of 0.81
which implied a high fit degree.
Conclusion
2
A model to evaluate mean blood glucose by OGTT is successfully established
and can be used as a simple method to evaluate blood glucose status in diabetic patients.
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