高同型半胱氨酸血症与2型糖尿病视网膜病变及胰岛素抵抗的关系  

Association of retinopathy and insulin resistance with hyperhomocysteinemia in the patients with type 2 diabetes

作　　者：李志红[1] 张云良[1] 郭淑琴[1] 

机构地区：[1]保定市第一中心医院内分泌科,河北保定071000

出　　处：《现代医学》2010年第1期25-29,共5页Modern Medical Journal

基　　金：河北省保定市科技局科技攻关项目(082F0022)

摘　　要：目的:探讨高同型半胱氨酸(Hcy)血症与2型糖尿病视网膜病变(DR)及胰岛素抵抗(IR)的关系。方法:ELISA法检测125例2型糖尿病患者及50例对照者血浆总Hcy浓度,依据Hcy水平将糖尿病患者再分为高Hcy组和正常Hcy组,比较两组的临床资料。结果:高Hcy组较正常Hcy组空腹血糖(FBG)、糖化血红蛋白(HbA1C)、胰岛素抵抗指数(HOMA-IR)均明显升高(P<0.05)。多元线性逐步回归分析示,FBG、HbA1C、HOMA-IR均为有统计学意义的Hcy决定因素;Logistic回归分析示,DR的发生与Hcy有关。结论:高Hcy水平是DR发生发展的危险因子,与IR相关。Objective： To evaluate the relationship among diabetic retinopathy（ DR）, insulin resistance（IR） and blood homocysteine （Hcy） and to discuss the influence of amino acid metabolism on the pathogenesis and development of DR and the effect of IR on Hcy. Methods： T2DM group（ according to the WHO diagnosis criteria of type 2 diabetes in 1999） with 125 the aged in-patients of endocrinology department was divided into a group with type 2 diabetic retinopathy （ DR group, 63 cases） and a group without retinopathy complications （ NDR group, 62 cases）. And the DR group was subdivided into background diabetic retinopathy group （BDR, 30 cases） and proliferative diabetic retinopathy （ PDR, 33 cases）. Fasting blood glucose （ FBG）, fasting insulin （ FINS ）, the blood lipids include the total cholesterol （ CHO）, the triglyceride （TG） et al, were measured for T2DM group and 50 control subjects（ CON group）. Then those patients with diabetes were divides into high Hcy group（ HHcy group） and normal Hcy group, according to the Hcy plasma level. And clinical indicators were compared between the two groups. Hcy was measured with enzyme linked immunosorbent assay by enzymatic reader. HOMA-IR was calculated. All of clinical data were analyzed retrospectively. Results： Plasma total Hcy level was significantly higher in the DR group [ （ 15.78 ±3.52） μmol· L-1] than in the NDR group [ （ 13.45 ±2.29） μmol· L-1] and the CON group [ （11.91 ± 2.30） μmol· L-1] （P 〈 0.01 ）. And it increased with the severity of retinopathy. Compared with the normal Hcy group, patients in the HHcy group had higher levels of FBG, HbA1C and HOMA-IR（P 〈0.05）. By stepwise regression analysis, FBG, HbA1C and HOMA-IR were the decisive and independent factors of plasma Hcy level in type 2 diabetes. DR （yes or not） as dependent variable and age, sex, body mass index（BMI）, CHO, TG, HbAlc and HOMA-IR as independent variable, logistic regression analysis results showed that d

关 键 词：2型糖尿病 同型半胱氨酸 糖尿病视网膜病变 胰岛素抵抗 

分 类 号：R587.2[医药卫生—内分泌] R771.3[医药卫生—内科学]