Hcy在2型糖尿病合并脂肪肝及高血压患者中的变化  

The serum homocysteine level in type 2 diabetes complicated with non-alcoholic fatty liver disease and hypertension

作　　者：陈燕铭[1] 张晓菲[2] 穆攀伟[1] 王曼曼[1] 林妙霞[1] 曾龙驿[1] 

机构地区：[1]中山大学附属第三医院,广州510630 [2]中山大学附属第六医院ICU,广州510655

出　　处：《中国卫生检验杂志》2011年第6期1406-1408,共3页Chinese Journal of Health Laboratory Technology

摘　　要：目的:探讨血清同型半胱氨酸水平在2型糖尿病(T2DM)合并非酒精性脂肪肝(NAFLD)及高血压患者中的变化。方法:将130例新诊断T2DM患者分为单纯T2DM组22例,T2DM合并高血压(高血压)组32例,T2DM合并NAFLD(NAFLD)组36例,糖尿病合并NAFLD及高血压(NAFLD合并高血压)组40例。测定血清同型半胱氨酸(Hcy)、空腹C肽(FCP)和胰岛素(FINS)、游离脂肪酸(FFA)、血脂谱、尿酸和肌酐等水平,并计算胰岛素抵抗指数(HOMR-IR)及胰岛素敏感指数(ISI)。结果:130例新诊断T2DM患者中,NAFLD占59.2%,高血压占53.8%,NAFLD合并高血压占30.0%。NAFLD组与NAFLD合并高血压组患者血清甘油三酯和尿酸水平均高于单纯T2DM组患者(P<0.05),NAFLD组与NAFLD合并高血压组患者血清FFA和Hcy水平高于单纯T2DM组与高血压组患者(P<0.01)。NAFLD组与NAFLD合并高血压组患者LnHOMA-IR高于单纯T2DM组与高血压组患者(P<0.05),但是前者的LnISI却小于后者(P<0.05)。结论:Hcy、甘油三酯、FFA及胰岛素抵抗是2型糖尿病患者合并NAFLD和高血压的危险因素;T2DM合并NAFLD患者血清Hcy水平高于T2DM合并高血压的患者,而且胰岛素抵抗更为明显。Objective：To observe the changes of serum homocysteine（Hcy） levels in type 2 diabetes（T2DM） complicated with non-alcoholic fatty liver disease（NAFLD） or hypertension.Methods： 130 newly diagnosed T2DM cases were divided into four groups： simple T2DM group,hypertension group,NAFLD group,hypertension complicated with NAFLD group.Serum levels of Hcy,free fatty acids（FFA）,triglyceride（TG）,low-density lipoprotein cholesterol（LDL-C）,high-density lipoprotein cholesterol（HDL-C）,fasting C-peptide（FCP）,fasting insulin（FINS）,glycation hemoglobin A1c（GHbA1c）,uric acid（UA） and creatinine were measured in laboratory.Insulin resistance index（HOMA-IR） and insulin sensitivity index（ISI） were calculated.Results： 59.2% newly diagnosed T2DM patients were complicated with NAFLD,53.8% were complicated with hypertension and 30.0% were complicated with both NAFLD and hypertension.The serum level of Hcy was higher in NAFLD complicated with hypertension group and NAFLD group than simple T2DM group and hypertension group（P〈0.01）,at the same time the serum levels of FFA and TG was also higher in NAFLD complicated with hypertension group and NAFLD group than simple T2DM group and hypertension group（P〈0.01）.Diabetes patients complicated with NAFLD had higher HOMR-IR and lower ISI than the patient who did not complicated with NAFLD（P〈0.01）.There was no difference for HDL-C,LDL-C,TC and FINS in each group.Conclusion： The results showed that Hcy,TG,FFA and IR were risk factors of T2DM complicated with NAFLD and hypertension.Furthermore,the prevalence of NAFLD was high in T2DM,and the serum level of Hcy was higher in T2DM patients complicated with NAFLD than those with hypertension.Insulin resistance was also more severe in T2DM patients complicated with NAFLD than those with hypertension.

关 键 词：2型糖尿病 脂肪肝 高血压 同型半胱氨酸 胰岛素抵抗 

分 类 号：R587.1[医药卫生—内分泌]