伴睡眠障碍T2DM患者血糖波动、血压变异、昼夜节律变化及意义

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Glycemic Variability，Blood Pressure Variability，Circadian Rhythm Changesand Their Significance in Type 2 Diabetes Mellitus Patients with Sleep Disorders

LI Li，FENG Yixue

（Departmentof Laboratory Medicine，Nanchong Hospital of Traditional Chinese Medicine，Nanchong 637o，China）

AbstractObjective：Toinvestigatethecharacteristicsof glyemicvariability，bloodpressurevariability，andcircadanythm changesin type2diabetes melitus（T2DM）patientswith sleepdisordersandanalyzetheircorrelations.Methods：Clinicaldataof 120 T2DM patients admitted between May2024andApril2025wereretrospectively analyzed.Sleepqualitywasasessed using the Pittsburgh Sleep Quality Index（PSQI）. Patients were divided into a sleep disorder group（SD group， n=68，PSQI>7 ）and a non-sleep disorder group（NSD group， n=52 ，PSQI≤7）. Time in range（TIR），mean amplitude of glycemic excursions（MAGE）， 24-hour systolic bloodpressure standard deviation（24h-SBP-SD），and nocturnal blood pressure dipping rate werecompared between thetwo groups，and theircorelations were analyzed.Results：TheSD grouphadsignificantlylower TIRand higher MAGE and 24 h-SBP-SD than the NSD group（all P<0.05 ）. Correlation analysis revealed that the PSQI total score was positively correlatedwith MAGE（ r=0 0.482，P<0.05， ）and 24h -SBP-SD （ r=0.416，P<0.05 ），and negatively correlated with TIR（r=- 0.523，P<0.05 ）. Conclusion：T2DM patients with sleep disorders exhibit more severe glycemic variability，blood pressure variability，andcircadianrythmdisruption，withspqualitycorrelatingwithteseindicators.Improvingslepandregulatigcicadianrhythmsmay represent novel intervention targets forstabilizing blood glucose and blood pressure in T2DM patients.

KeywordsType2diabetes melitus；Slpdisorders；Glycemic variability；Blod pressure variabity；Circadianrhythm；Sleep quality; Pitsburgh Sleep Quality Index;Correlation analysis

中图分类号：R544.1;R338.63 文献标识码：A doi：10.3969/j.issn.2095-7130.2025.10.023

2型糖尿病（Type2diabetesmellitus，T2DM）的传统血糖管理以糖化血红蛋白（Hemoglobin A1c，HbA1c）水平达标为标准[1]，但研究发现在HbA1c水平相近患者中，其并发症风险仍存在显著差异，指出在控制血糖水平外，血糖波动、血压变异亦是诱发DM并发症的危险因素[24]。（剩余4451字）