Study On The Correlation Between Glucose Excursions And Serum Cystatin C In Type 2 Diabetes

Objective Using dynamic glucose monitoring system to observe the level of dynamic glucose excursion,and investigate the correlation between glucose excrusions and the serum Cystatin C（CysC）in patients with type 2 diabetes mellitus（T₂DM）.Methods 164 cases of T2DM in clinic were selected.All the patients underwent continuous 72 hours dynamic glucose monitoring.The parameters of glucose excursion were calculated,including blood glucose standard deviation（SD）,average blood glucose level（MBG）.According to the monitoring results,the cases were divided into high blood glucose excursion group and low blood glucose excursion group.To analyze the correlation of SD and CysC between the two groups,CysC level and other biochemical parameters were also detected.Results 1.In the two groups,the significance among age,Urea nitrogen,uric acid,glomerular filtration rate（e GFR）,and CysC levels were statistically significant（P<0.05）.The mean value of CysC and the percentage of CysC increased in high blood glucose excursion group were higher than in low blood glucose excursion group.The values of SD and CysC among 164 cases,showed a positive correlation,and the correlation coefficient is 0.344（P<0.01）.Both in the high blood glucose excursion group and low blood glucose excursion group,SD values were positively correlated with CysC values,and the correlation coefficient is 0.604（P<0.01）and 0.331（P<0.01）,respectively.2.Compared the two groups,the incidence of diabetic peripheral arterial disease（PAD）,diabetic peripheral neuropathy（DPN）,diabetic retinopathy（DR）,diabetic nephropathy（DN） in high blood glucose excursion group were higher than those in the low blood glucose excursion group.3.Multivariate stepwise regression analysis showed that : WC,GA,FPG,FIns,Urea nitrogene GFRand SDwere indepent risk factors for CysC.SD had the greatest contribution（β=0.112,SE =0.025,P=0.000）.4.Comparison of two groups of cystatin C based on e GFR levels:According to the level of e GFR was divided into e GFR≥90、75≤e GFR<90、60≤e GFR<75、30≤e GFR<60 and e GFR < 30 ml·min-1·1.73 m-2 group,removal of e GFR < 60,to compare average CysC and do the related analysis,found that in e GFR≥90 and 75≤GFR<90 levels,CysC in high blood glucose excursion group were higher than those in the low blood glucose excursion group,with statistical significance（P<0.01、P<0.05）,in 60≤e GFR<75,CysC in high blood glucose excursion group were higher than those in the low blood glucose excursion group,but no statistical significance（P>0.05）.Conclusion In type 2 diabetes mellitus,There were significantly positive correlation between dynamic glucose excursion and CysC,the greater the blood glucose excursion,the higher the CysC level.