Relationship Between HbA1c Variability And Microalbuminria In Type 2 Diabetic Patients

Objective: To investigate the relationship between Hb A1 c variability and microalbuminuria in patients with type 2 diabetes mellitus and the factors influencing the Hb A1 c variability.Methods: Ninety patients with type 2 diabetes who were regularly admitted to our hospital from October 2015 to December 2017 were retrospectively collected.The records of these patients within 2 years were collected: Hb A1 c,FBG,ACR,LDL-C,HDL-C,TG,BP,BMI,duration,sex,age,hypoglycemic methods.The individual SD-Hb A1c(standard deviation of glycosylated hemoglobin),SD-FBG(standard deviation of fasting plasma glucose),and the average of the above other indexes were calculated.Patients were divided into Norm group(Normal albuminuria)and Micr group(Microalbuminuria)according to the average ACR level.The correlation between SD-Hb A1 c and microalbuminuria was analyzed by pearson correlation analysis and multiple stepwise regression analysis.In addition,it was explored to some of the factors that affect SD-Hb A1 c.Results:in the Micr group,the duration of diabetes and average FBG,SD-FBG,mean Hb A1 c,SD-Hb A1 c,and mean SBP levels were higher(P<0.05)than in the Norm group,and the average HDL-C was lower than the Norm group(P< 0.05).Pearson correlation analysis showed that there was a positive correlation between SD-Hb A1 c and urinary albumin/creatinine ratio(ACR)(r = + 0.465,P < 0.01).Multiple linear regression analysis showed that SD-Hb A1 c was independently associated with ACR(P<0.01)and was not significantly associated with SD-FBG,mean FBG,mean Hb A1 c,and mean HDL-C(P>0.05),while Pearson correlation analysis averaged Hb A1c(r= +0.306,P<0.01),BMI(r= +0.382,P<0.01),FBP(r= + 0.257,P<0.01)were positively correlated with SD-Hb A1 c,and the hypoglycemic approach and SD-Hb A1 c was no significant correlation between Hb A1c(F=0.302,P>0.05).Conclusions: One,the occurrence of urinary albumin in patients with type 2 diabetes is influenced by Hb A1 c variability,which may be another unfavorable factor involved in the development of type 2 diabetic nephropathy.Two,increases in obesity,fasting blood glucose,and mean blood glucose levels increase the variability of glycated hemoglobin.It can be seen that the consistency of glycemic control for the protection of renal function in patients with type 2 diabetes is very important.