Study on the correlation between time within the target range of glucose and urinary microalbumin level in patients with type 2 diabetes

doi:10.3877/cma.j.issn.2095-9605.2022.04.006

Abstract

Abstract:

Objective

To explore the correlation between time in range of glucose (TIR, Time In Range) and urinary microalbumin level.

Methods

this study, 126 patients with type 2 diabetes who were hospitalized in the Department of Endocrinology, Xinjiang Medical University from January 2020 to March 2022 were included. The urinary albumin/creatinine ratio (UACR) of 30 mg/g was used as the entry point, the ratio less than 30 mg/g was used as the NUA group (80 cases), and 30 mg/g≤UACR<300 mg/g was used as the UA group (46 cases). The difference between the two groups of indicators and their correlation with UACR level were compared, the risk factors of UACR level were analyzed by binary Logistic regression model, and the difference of indicators in the two groups was analyzed, and the contribution difference of each indicator was analyzed by multiple Logistic regression. At the same time, hierarchical TIR analysis was performed to compare the differences between different groups of UACR, and finally Pearson correlation analysis was performed for related indicators.

Results

There were statistically significant differences in age, disease course, mean blood glucose, TIR, time below the glucose target range (TBR), glycosylated hemoglobin, triglycerides, high density lipoprotein cholesterol, low density lipoprotein cholesterol, estimated glomerular filtration rate (eGFR), creatinine, cystatin C and coefficient of variation between the two groups (P<0.05). TIR, low density lipoprotein, cystatin C and coefficient of variation were correlated with the occurrence of urinary microalbumin (P<0.05). There was a negative correlation between TIR and UACR level (P<0.05). LDL-C, cystatin C and coefficient of variation were positively correlated with UACR level (P<0.05).

Conclusions

The level of urinary microalbumin in type 2 diabetes patients is negatively correlated, and when the level of TIR decreases, the level of urinary microalbumin increases significantly. As an important indicator of blood glucose monitoring, TIR can well evaluate the blood sugar control of diabetic patients and predict the occurrence of microalbuminuria.

Key words: Time in range, Glucose fluctuation indicators, Diabetes nephropathy, Diabetic complications

Di Shen, Li Quan, Cunyu Liang, Qi Meng, Yusufu Aibibai·. Study on the correlation between time within the target range of glucose and urinary microalbumin level in patients with type 2 diabetes[J]. Chinese Journal of Obesity and Metabolic Diseases(Electronic Edition), 2022, 08(04): 249-255.

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Figures/Tables 8

References 14

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项目	NUA组（80例）	UA组（46例）	检验值	P值
年龄（岁）	51.04±13.61	58.94±10.75	-3.374	0.001
病程（年）	8.38±7.86	11.70±8.56	-2.21	0.029
性别（男）	50	33	3.492	0.174
吸烟史（吸烟）	39	28	0.887	0.346
BMI（kg/m²）	25.29±4.51	25.46±3.34	-0.221	0.825
收缩压（mmHg）	128.33±16.27	126.39±16.62	0.595	0.553
舒张压（mmHg）	77.99±11.01	74.13±10.23	1.942	0.054
空腹C肽（ng/mL）	1.43±0.96	1.66±1.10	-1.213	0.228
HbAlc（%）	8.67±2.00	7.54±4.14	2.064	0.041
TG（mmol/L）	1.66±1.05	3.18±2.48	-4.81	0.00
TC（mmol/L）	4.08±1.04	3.76±2.20	1.13	0.26
HDL-C（mmol/L）	1.04±0.28	1.74±1.10	-5.396	0.00
LDL-C（mmol/L）	2.68±0.82	3.50±1.86	-3.41	0.001
eGFR[mL/(min·1.73m²) ]	109.48±29.49	97.04±37.76	2.22	0.029
肌酐（μmol/L）	67.64±14.53	77.63±23.98	-2.91	0.004
胱抑素C（mg/L）	0.88±0.22	1.09±0.34	-4.158	0.000
血尿酸（μmol/L）	327.18±155.62	346.06±155.66	-0.732	0.465

项目	NUA组（80例）	UA组（46例）	检验值	P值
年龄（岁）	51.04±13.61	58.94±10.75	-3.374	0.001
病程（年）	8.38±7.86	11.70±8.56	-2.21	0.029
性别（男）	50	33	3.492	0.174
吸烟史（吸烟）	39	28	0.887	0.346
BMI（kg/m²）	25.29±4.51	25.46±3.34	-0.221	0.825
收缩压（mmHg）	128.33±16.27	126.39±16.62	0.595	0.553
舒张压（mmHg）	77.99±11.01	74.13±10.23	1.942	0.054
空腹C肽（ng/mL）	1.43±0.96	1.66±1.10	-1.213	0.228
HbAlc（%）	8.67±2.00	7.54±4.14	2.064	0.041
TG（mmol/L）	1.66±1.05	3.18±2.48	-4.81	0.00
TC（mmol/L）	4.08±1.04	3.76±2.20	1.13	0.26
HDL-C（mmol/L）	1.04±0.28	1.74±1.10	-5.396	0.00
LDL-C（mmol/L）	2.68±0.82	3.50±1.86	-3.41	0.001
eGFR[mL/(min·1.73m²) ]	109.48±29.49	97.04±37.76	2.22	0.029
肌酐（μmol/L）	67.64±14.53	77.63±23.98	-2.91	0.004
胱抑素C（mg/L）	0.88±0.22	1.09±0.34	-4.158	0.000
血尿酸（μmol/L）	327.18±155.62	346.06±155.66	-0.732	0.465

指标	NUA组（80例）	UA组（46例）	检验值	P值
TIR	0.68±0.21	0.57±0.15	3.084	0.003
TAR	0.30±0.22	0.38±0.16	-2.248	0.026
TBR	0.02±0.03	0.04±0.06	-2.511	0.013
血糖波动幅度（mmol/L)	6.35±2.64	7.04±2.26	-1.498	0.137
血糖平均值（mmol/L)	8.79±1.91	9.88±2.55	-2.729	0.007
平均血糖标准差（mmol/L)	2.60±0.97	2.71±0.85	-0.645	0.520
CV	0.25±0.07	0.31±0.05	-4.741	0.000

指标	NUA组（80例）	UA组（46例）	检验值	P值
TIR	0.68±0.21	0.57±0.15	3.084	0.003
TAR	0.30±0.22	0.38±0.16	-2.248	0.026
TBR	0.02±0.03	0.04±0.06	-2.511	0.013
血糖波动幅度（mmol/L)	6.35±2.64	7.04±2.26	-1.498	0.137
血糖平均值（mmol/L)	8.79±1.91	9.88±2.55	-2.729	0.007
平均血糖标准差（mmol/L)	2.60±0.97	2.71±0.85	-0.645	0.520
CV	0.25±0.07	0.31±0.05	-4.741	0.000

项目	β	SE	Wald χ²值	P值	OR	95%CI
TIR（%）	-0.103	0.021	23.120	0.000	0.902	0.865~0.941
LDL-c（mmol/L）	0.841	0.389	4.679	0.031	2.319	1.082~4.971
胱抑素C（mg/L）	3.823	1.527	6.269	0.012	45.736	2.294~911.748
变异系数（%）	0.145	0.036	16.573	0.000	1.156	1.078~1.240

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