血液相关指标、体成分、营养状态对扫描式葡萄糖监测设备准确性的影响因素分析

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摘要 目的: 通过分析研究对象的血常规、生化、血糖、体成分、营养状态等相关指标,探寻可能影响扫描式葡萄糖监测设备（flash glucose monitoring,FGM）准确性的相关因素。方法: 选取2021年4月至2023年4月于中国科学技术大学附属第一医院（安徽省立医院）老年医学科住院的2型糖尿病患者43例,收集患者的一般资料、血液相关指标、体成分、营养状态等参数。将空腹及餐后2 h静脉血糖分别与FGM葡萄糖数值两两配对,根据配对血糖平均相对误差（mean absolute relative difference,MARD）,以15%为界将患者分为准确组（MARD<15%）及不准确组（MARD>15%）。其中,空腹FGM准确组（n=25）,空腹FGM不准确组（n=18）;餐后2h FGM准确组（n=32）,餐后2h FGM不准确组（n=11）。运用Clarke误差栅格分析法来评价FGM的准确性,采用二元Logistic回归分析探寻FGM准确性的影响因素。结果: 共纳入43例研究对象,收集86对血糖数值,以静脉血糖为参考值,对FGM葡萄糖值进行Clarke误差栅格分析,结果显示90.7%落在A区,9.3%落在B区,100%落在A+B区,平均MARD为11.7%。二元Logistic回归分析结果显示,营养不良是影响空腹FGM的独立危险因素,OR值为7.979（95%CI：1.540~41.335,P=0.013）,同时,营养不良也是影响餐后2 h FGM准确性的独立危险因素,OR值为7.769（95%CI：1.117~59.370,P=0.048）。结论: 本项目所使用FGM传感器准确性符合国际标准,虽在个别患者的检测过程中出现与静脉血糖较大差异,但总体准确度较高。FGM空腹及餐后2 h葡萄糖监测准确性与营养不良相关,与年龄、体成分及其他血常规、生化指标无关。

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	邵丽洁
	朱翔
	朱文静
	殷实
	陈焱焱
	汪兰兰

关键词 ： 2型糖尿病, 血糖监测, 扫描式葡萄糖监测系统, 影响因素分析

Abstract：Objective This study aims to explore risk factors impacting the accuracy of flash glucose monitoring (FGM) by analyzing various parameters including blood routine, biochemical indicators, blood glucose, body composition, and nutritional status among patients. Methods Patients were selected with type 2 diabetes who were hospitalized in the department of Gerontology at the First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital) from April 2021 to April 2023. Patients' general information was collected, such as blood-related indicators, Body composition, malnutrition, and other parameters. FGM glucose readings were compared with fasting and 2-hour postprandial venous blood glucose respectively. Based on the paired blood glucose mean relative error (MARD) with its value 15% as a threshold, those with MARD less than 15% are the accurate group (MARD<15%), and those with more than 15% are the inaccurate group (MARD>15%). Among them, the patients were divided into the fasting FGM accurate group (n=25) and inaccurate group (n=18), and 2-hour postprandial FGM accurate group (n=32) and inaccurate group (n=11). Clarke grid analysis was used to evaluate the accuracy of FGM. Binary logistic regression analysis was performed to identify the independent risk factors that influence the accuracy of FGM. Results Forty-three subjects were included, yielding 86 pairs of blood glucose values. Clarke grid error analysis was performed on the FGM glucose values with venous blood glucose as the reference value. The results showed that 90.7% falls in area A, 9.3% falls in area B, and 100 % falls in area A+B, with an average MARD of 11.7%. Our results showcase that malnutrition is an independent risk factor affecting fasting FGM with an OR value of 7.979(95%CI 1.540-41.335, P=0.013) and it is also an independent risk factor affecting the accuracy of postprandial FGM with an OR value of 7.769(95% CI 1.117-59.370, P=0.048). Conclusion The FGM sensor used in this study met international standards for accuracy. Although the venous blood glucose is very different for a few individual patients during testing process, the overall accuracy for all patients is relatively high. Malnutrition was identified as a independent risk factor impacting FGM accuracy for fasting and 2-hour postprandial glucose levels, while age, body composition, and other blood routine and biochemical indicators showed no significant association with FGM accuracy.

Key words： type 2 diabetes blood glucose monitoring flash glucose monitoring system root cause analysis

收稿日期: 2024-01-26

中图分类号:

R587.1

基金资助:安徽省科技重大专项“重症患者呼吸热量代谢测量关键技术研究” (2020b07050001)

通讯作者: 汪兰兰,E-mail：doctorwll@163.com

引用本文:

邵丽洁, 朱翔, 朱文静, 殷实, 陈焱焱, 汪兰兰. 血液相关指标、体成分、营养状态对扫描式葡萄糖监测设备准确性的影响因素分析[J]. 湖南师范大学学报(医学版), 2024, 21(2): 127-132. SHAO Lijie, ZHU Xiang, ZHU Wenjing, YIN Shi, CHEN Yanyan, WANG Lanlan. Analysis of The Factors of Blood-related Indicators, Body Composition, and Nutritional Status That Influence on The Accuracy of Flash Glucose Monitoring Equipment. HuNan ShiFan DaXue XueBao(YiXueBan), 2024, 21(2): 127-132.

链接本文:

http://yxb.hunnu.edu.cn/CN/ 或 http://yxb.hunnu.edu.cn/CN/Y2024/V21/I2/127

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