2型糖尿病患者心功能与同型半胱氨酸水平的相关性研究  

Association of cardiac function and homocysteine in patients with type 2 diabetes mellitus

作　　者：张春槐 黄曙锋 朱金锦 Zhang Chunhuai;Huang Shufeng;Zhu Jinjin(Department of Endocrinology,the Sixth People's Hospital of Cixi,Cixi,Zhejiang 315300,China)

机构地区：[1]慈溪市第六人民医院内分泌科,浙江省慈溪315300

出　　处：《中国基层医药》2018年第24期3133-3136,共4页Chinese Journal of Primary Medicine and Pharmacy

基　　金：浙江省慈溪市科技计划项目(CN2015033).

摘　　要：目的探讨2型糖尿病(T2DM)患者心功能与同型半胱氨酸(Hcy)水平的相关性。方法选取2015年5月至2016年4月慈溪市第六人民医院收治的T2DM患者120例为研究对象,根据患者Hcy水平将其分为糖尿病(DM)组(Hcy水平<15μmol/L)42例和Hcy+DM组(Hcy水平≥15μmol/L)78例,再选择同一时期来医院进行体检的健康人群50例作为对照组。分析比较三组患者各项生理生化指标和心功能指标与Hcy之间的相关性。结果T2DM患者Hcy、糖化血红蛋白(HbA1c)和空腹血糖(FBG)水平均显著高于对照组[Hcy:(11.26±2.16)μmol/L比(8.24±1.25)μmol/L;HbA1c:(7.46±1.47)%比(5.02±1.73)%;FBG:(7.87±2.75)mmol/L比(5.78±2.83)mmol/L,均P<0.05],左心室舒张早期左房室瓣最大血流速度/舒张晚期最大血流速度(E/A)值和左心射血分数(LVEF)值均显著低于对照组。Hcy+DM组Hcy、HbA1c和FBG水平显著高于DM组,E/A值和LVEF值显著低于DM组。Spearman相关系数分析显示HbA1c和FBG水平与Hcy水平之间呈正相关(r=0.157、0.112,均P<0.05),而E/A值和LVEF值与Hcy水平之间呈负相关(r=-0.264、-0.394,均P<0.05);logistic回归分析显示影响患者E/A值和LVEF值的独立危险因素均为Hcy水平(P=0.015、0.001)。结论Hcy水平的检测可对T2DM患者心功能进行预测和评价。Objective To investigate the correlation between cardiac function and homocysteine(Hcy) level in type 2 diabetes mellitus (T2DM) patients. Methods From May 2015 to April 2016,120 patients with T2DM in the Sixth People's Hospital of Cixi were selected.According to the level of Hcy,the patients were divided into DM group (Hcy level < 15μmol/L,42 cases) and Hcy+ DM group (Hcy level≥15 μmol/L,78 cases).And 50 healthy people were selected as control group.The correlations between various physiological and cardiac functional parameters and Hcy level among the three groups were analyzed. Results The levels of Hcy,HbA1c and FBG in the DM group were significantly higher than those in the control group [Hcy: (11.26±2.16)μmol/L vs.(8.24±1.25)μmol/L,HbA1c: (7.46±1.47)% vs.(5.02±1.73)%,FBG: (7.87±2.75)mmol/L vs.(5.78±2.83)mmol/L,all P<0.05].The E/A value and LVEF value in the DM group were significantly lower than those in the control group(all P<0.05).The Hcy,HbA1c,and FBG levels in the Hcy+ DM group were significantly higher than those in the DM group,and the E/A value and LVEF value in the Hcy+ DM group were significantly lower than those in the DM group(all P<0.05).Spearman's correlation coefficient analysis showed that there was a positive correlation between HbA1c and FBG levels and Hcy levels (r=0.157,0.112,all P<0.05),but there was a negative correlation between E/A and LVEF values and Hcy levels (r=-0.264,-0.394,all P<0.05).Logistic regression analysis showed that the independent risk factor affecting the E/A and LVEF values was Hcy levels (P=0.015,0.001). Conclusion The level of Hcy in patients with diabetes can reflect the status of heart function.The higher the level of Hcy,the worse the heart function.The detection of Hcy level can help to predict and evaluate cardiac function in patients.

关 键 词：糖尿病 2型 半胱氨酸 心脏功能试验 血糖 血红蛋白A 糖基化 预测 

分 类 号：R587.1[医药卫生—内分泌]