持续葡萄糖监测技术在糖肝共管中的应用现状与展望

doi:10.12114/j.issn.1007-9572.2025.0582

中国全科医学 ›› 2026, Vol. 29 ›› Issue (31): 4521-4527.DOI: 10.12114/j.issn.1007-9572.2025.0582

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持续葡萄糖监测技术在糖肝共管中的应用现状与展望

肖智利¹, 卢晨霞²^,³^,⁴^,⁵, 朱绘²^,³^,⁴, 张佳¹^,²^,³^,⁴, 陈壮壮¹, 孙巍¹, 刘向楚煊¹, 罗成¹, 肖明中¹^,²^,³^,⁴^,^*(), 李晓东¹^,²^,³^,⁴

1．430065　湖北省武汉市，湖北中医药大学
2．430061　湖北省武汉市，湖北省中医院肝病研究所　中医肝肾研究及应用湖北省重点实验室
3．430061　湖北省武汉市，湖北中医药大学附属医院
4．430074　湖北省武汉市，湖北省中医药研究院
5．100053　北京市，中国中医科学院广安门医院代谢病研究所

收稿日期:2025-12-09 修回日期:2026-06-10 出版日期:2026-11-05 发布日期:2026-10-10
通讯作者: 肖明中
作者贡献：
肖智利承担本研究的总体设计、文献调研与数据整合及论文主体撰写；卢晨霞、朱绘、张佳负责文稿的学术审修、质量监控与编辑校对；陈壮壮、孙巍、刘向楚煊、罗成参与收集资料及图表编排；肖明中、李晓东主导研究思路构建，对论文撰写进行全程指导并终审定稿。
基金资助:
国家自然科学基金面上项目(82274352); 国家中医药管理局科技项目(GZY-KJS-2025-009); 湖北省自然科学基金资助项目(2023AFD178，2023AFD129); 中国博士后科学基金第78批面上资助项目

Application and Future Prospects of CGM Technology in Co-management of MAFLD and T2DM

XIAO Zhili¹, LU Chenxia²^,³^,⁴^,⁵, ZHU Hui²^,³^,⁴, ZHANG Jia¹^,²^,³^,⁴, CHEN Zhuangzhuang¹, SUN Wei¹, LIU Xiangchuxuan¹, LUO Cheng¹, XIAO Mingzhong¹^,²^,³^,⁴^,^*(), LI Xiaodong¹^,²^,³^,⁴

1. Hubei University of Chinese Medicine, Wuhan 430065, China
2. Institute of Liver Diseases, Hubei Key Laboratory of the Theory and Application Research of Liver and Kidney in Traditional Chinese Medicine, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan 430061, China
3. Affiliated Hospital of Hubei University of Chinese Medicine, Wuhan 430061, China
4. Hubei Province Academy of Traditional Chinese Medicine, Wuhan 430074, China
5. Institute of Metabolic Diseases, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China

Received:2025-12-09 Revised:2026-06-10 Published:2026-11-05 Online:2026-10-10
Contact: XIAO Mingzhong

摘要/Abstract

摘要： 持续葡萄糖监测（CGM）技术能够提供持续全面的血糖信息，在2型糖尿病（T2DM）与代谢相关脂肪性肝病（MAFLD）的共病管理中展现出重要潜力。本文围绕CGM技术在糖肝共管中的应用展开论述，概述T2DM与MAFLD共同发病机制及当前共同管理现状，继而系统介绍CGM的核心评价指标及其在T2DM合并MAFLD患者中的特征性改变。CGM揭示了肝功能损伤与血糖波动、胰岛素抵抗之间的相关性，并弥补了糖化血红蛋白在评估此类共病患者血糖状况时的局限性。在临床管理方面，CGM有助于实现个体化、精细化的血糖控制，并可能通过改善血糖稳态来延缓MAFLD的进展。CGM作为一项关键技术应用于糖肝共管一体化策略中具有重要价值。

Abstract:

Continuous glucose monitoring (CGM) technology can provide continuous and comprehensive blood glucose information, demonstrating significant potential in the co-management of type 2 diabetes mellitus (T2DM) and metabolic dysfunction-associated fatty liver disease (MAFLD). This article focuses on the application of CGM technology in the co-management of MAFLD and T2DM. This review outlines the shared pathogenesis of T2DM and MAFLD and the current status of their co-management, then systematically introduces the core evaluation indicators of CGM and its characteristic changes in patients with T2DM complicated by MAFLD. CGM reveals the correlation between liver dysfunction, blood glucose fluctuations, and insulin resistance, and addresses the limitations of glycated hemoglobin in assessing the blood glucose status of such comorbid patients. In terms of clinical management, CGM facilitates the achievement of individualized and precision blood glucose control and may delay the progression of MAFLD by improving blood glucose homeostasis. As a key technology, CGM has important value when applied to the integrated strategy of the co-management of MAFLD and T2DM.

Key words: Metabolic dysfunction-associated fatty liver disease, Type 2 diabetes mellitus, Continuous glucose monitoring, Co-management of MAFLD and T2DM

肖智利,卢晨霞,朱绘,等. 持续葡萄糖监测技术在糖肝共管中的应用现状与展望[J]. 中国全科医学, 2026, 29(31): 4521-4527. DOI: 10.12114/j.issn.1007-9572.2025.0582.
XIAO Zhili,LU Chenxia,ZHU Hui, et al. Application and Future Prospects of CGM Technology in Co-management of MAFLD and T2DM[J]. Chinese General Practice, 2026, 29(31): 4521-4527. DOI: 10.12114/j.issn.1007-9572.2025.0582.

图/表 2

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研究人群	CGM相关指标主要结论
MAFLD患者^[24]	MAFLD患者在糖耐量正常阶段已出现血糖波动幅度增大在糖耐量状态相同的情况下，MAFLD人群的血糖水平标准差及餐后3 h血糖水平高于非MAFLD人群（P<0.05）
T2DM合并MAFLD患者^[25]	与T2DM组相比，T2DM合并MAFLD组的TIR缩短、TAR增长（P<0.05）
T2DM合并MAFLD患者^[26]	与T2DM的人群相比，T2DM合并MAFLD人群的GMI增大、TAR增长、TIR缩短、TBR缩短（P<0.05） GMI与MAFLD发生风险显著相关（P<0.05）
不同糖代谢特征人群^[27]	肝脏脂肪含量增高是持续性高血糖和血糖波动性增大的独立危险因素（P<0.05）
T2DM合并MAFLD患者^[28]	CAP和LSM随着TIR的增加而降低（P<0.05） TIR是CAP、LSM的相关因素（r=-0.695和-0.735，P<0.05）
T2DM患者^[29]	肝脏脂肪含量每增加10 dB/m，患者血糖达标（TIR>70%）的可能性降低12.0%，而高血糖时间（TAR>25%）增加10.2%
T2DM合并慢性肝病患者^[30]	MG水平和日内最大血糖差值随肝功能下降明显升高（P<0.001和P=0.005）
慢性肝病患者^[31]	随着肝功能的降低，患者MG水平升高和胰岛素抵抗显著增强（P=0.027 8和P<0.000 1），而HbA_1c水平反而下降（P<0.000 1）
T2DM患者^[32]	TIR负向预测肝脏硬度值（β=-0.75，P<0.001），HOMA-IR正向预测肝脏硬度值（β=0.21，P=0.025）与TIR Q4患者相比，TIR Q1患者MAFLD（OR=1.96，95%CI=1.07~3.62，P=0.027）及进展期肝纤维化（OR=3.82，95%CI=1.17~12.50，P=0.027）患病风险增加
MAFLD儿童患者^[33]	高血糖与肝纤维化之间呈正相关（r=0.65，P<0.05），血糖水平越高，肝纤维化的程度可能越严重
肝硬化患者^[34]	GMI和HbA_1c水平存在差异[平均差值为0.35%（95%CI=0.17%~0.63%）]

研究人群	CGM相关指标主要结论
MAFLD患者^[24]	MAFLD患者在糖耐量正常阶段已出现血糖波动幅度增大在糖耐量状态相同的情况下，MAFLD人群的血糖水平标准差及餐后3 h血糖水平高于非MAFLD人群（P<0.05）
T2DM合并MAFLD患者^[25]	与T2DM组相比，T2DM合并MAFLD组的TIR缩短、TAR增长（P<0.05）
T2DM合并MAFLD患者^[26]	与T2DM的人群相比，T2DM合并MAFLD人群的GMI增大、TAR增长、TIR缩短、TBR缩短（P<0.05） GMI与MAFLD发生风险显著相关（P<0.05）
不同糖代谢特征人群^[27]	肝脏脂肪含量增高是持续性高血糖和血糖波动性增大的独立危险因素（P<0.05）
T2DM合并MAFLD患者^[28]	CAP和LSM随着TIR的增加而降低（P<0.05） TIR是CAP、LSM的相关因素（r=-0.695和-0.735，P<0.05）
T2DM患者^[29]	肝脏脂肪含量每增加10 dB/m，患者血糖达标（TIR>70%）的可能性降低12.0%，而高血糖时间（TAR>25%）增加10.2%
T2DM合并慢性肝病患者^[30]	MG水平和日内最大血糖差值随肝功能下降明显升高（P<0.001和P=0.005）
慢性肝病患者^[31]	随着肝功能的降低，患者MG水平升高和胰岛素抵抗显著增强（P=0.027 8和P<0.000 1），而HbA_1c水平反而下降（P<0.000 1）
T2DM患者^[32]	TIR负向预测肝脏硬度值（β=-0.75，P<0.001），HOMA-IR正向预测肝脏硬度值（β=0.21，P=0.025）与TIR Q4患者相比，TIR Q1患者MAFLD（OR=1.96，95%CI=1.07~3.62，P=0.027）及进展期肝纤维化（OR=3.82，95%CI=1.17~12.50，P=0.027）患病风险增加
MAFLD儿童患者^[33]	高血糖与肝纤维化之间呈正相关（r=0.65，P<0.05），血糖水平越高，肝纤维化的程度可能越严重
肝硬化患者^[34]	GMI和HbA_1c水平存在差异[平均差值为0.35%（95%CI=0.17%~0.63%）]

持续葡萄糖监测技术在糖肝共管中的应用现状与展望

Application and Future Prospects of CGM Technology in Co-management of MAFLD and T2DM

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