【摘要】 目的 描述基于标准化管理下糖尿病与睡眠的关系，为2型糖尿病（type 2 diabetes mellitus, T2DM）患者血糖控制提供相关依据。方法 选择2020-01-01/2021-07-27日在国家标准化代谢性疾病管理中心（National Metabolic Management Center, MMC）延安大学附属医院分中心接受治疗和管理的358例T2DM患者为研究对象，按年龄将T2DM患者分为青年组（≤40岁）,中年组（41～59岁）和老年组（≥60岁）。收集患者性别、年龄及睡眠情况，检测患者空腹血糖（fasting blood glucose, FBG）、餐后2 h血糖（2-hour postprandial glucose, 2hPG）、糖化血红蛋白（glycosylated hemoglobin, HbA₁c）、C肽、甘油三酯（triglyceride, TG）、总胆固醇（total cholesterol, TC）、高密度脂蛋白胆固醇（high-density lipoprotein cholesterol, HDL-C）、低密度脂蛋白胆固醇（low-density lipoprotein cholesterol, LDL-C）水平。分析睡眠情况（夜间睡眠时长、睡眠质量及午睡时长）与各项指标之间的关系。结果 不同年龄组患者的病程、SBP、体质量、葡萄糖120 min、HbA₁c、TG、HDL-C、LDL-C水平组间比较差异具有统计学意义（P<0.05）;不同睡眠质量、午睡时长的患者各项临床指标间差异无统计学意义（P>0.05）。分析发现夜间睡眠时长<6 h患者中，3组患者的葡萄糖0 min、病程、TC、LDL-C水平组间比较差异均具有统计学意义（P均<0.05）。夜间睡眠时长6～8 h, 3组患者的病程、收缩压组间比较差异具有统计学意义（P<0.01）。夜间睡眠时长>8 h, 3组患者的病程、体质量指数（body mass index, BMI）、收缩压、HbA₁c、LDL-C水平组间比较差异具有统计学意义（P<0.05）。睡眠良好状态下，3组患者的病程、BMI、收缩压、HbA₁c、TC、LDL-C水平组间比较差异具有统计学意义（P<0.05）;睡眠欠佳状态下，3组患者的病程、收缩压、腰围组间比较差异具有统计学意义（P<0.05）。结论 不同睡眠质量和午睡时长的T2DM患者各项临床指标无明显差异，但不同年龄的患者不同睡眠时长、睡眠质量的多项临床指标存在明显差异。更多还原

【Abstract】 Objective To describe the relationship between diabetes mellitus and sleep under standardized management, and to provide relevant evidences for blood glucose control in patients with type 2 diabetes mellitus（T2DM）. Methods A total of 358 patients with T2DM treated and managed in the National Metabolic Management Center（MMC） branch center affiliated author′s hospital from January 1, 2020 to July 27, 2021 were selected as the study subjects, the patients were divided into young group（≤40 years）, middle-aged group（41-59 years） and elderly group（≥60 years） according to age. The gender, age and sleep status of the patients were collected, and the levels of fasting blood glucose（FBG）, 2-hour postprandial glucose（2hPG）, glycosylated hemoglobin（HbA₁c）, C-peptide, triglyceride（TG） and total cholesterol（TC）, high-density lipoprotein cholesterol（HDL-C）, low-density lipoprotein cholesterol（LDL-C） were tested. The relationship between sleep status（nighttime sleep duration, sleep quality and siesta duration） and various indicators were analyzed. Results There were significant differences in the course of disease, SBP, body mass, 120 min glucose, HbA₁c, TG, HDL-C and LDL-C（P<0.05）; there was no difference in clinical indicators among patients with different sleep quality and siesta duration（P>0.05）. Among patients with nighttime sleep duration < 6 h, there were significant differences in 0 min glucose, course of disease, TC and LDL-C among 3 groups（all P<0.05）. When nighttime sleep duration was 6-8 h, there were statistically significant differences in the course of disease and systolic blood pressure among the 3 groups（P<0.01）. There were statistically significant differences in the course of disease, body mass index（BMI）, systolic blood pressure, HbA₁c and LDL-C levels among the 3 groups of patients with nighttime sleep duration >8 h（P<0.05）. Under the good sleep status, there were statistically significant differences in the course of disease, BMI, systolic blood pressure, HbA₁c, TC and LDL-C levels among the 3 groups（P<0.05）; under the poor sleep status, there were statistically significant differences in the course of disease, systolic blood pressure and waist circumference among the 3 groups（P<0.05）.Conclusion There were no significant differences in clinical indicators among T2DM patients with different sleep duration, sleep quality and siesta duration, but there were significant differences in clinical indicators of different sleep duration and sleep quality among T2DM patients with different ages.更多还原