同型半胱氨酸与2型糖尿病合并早期肾病的关系  

Relationship between homocysteine and incipient diabetic nephropathy in type 2 diabetes mellitus

作　　者：智喜梅[1] 梁奕铨[2] 肖亦斌[2] 廖瑛[2] 廖志红[2] 余斌杰[2] 

机构地区：[1]广东省人民医院老年病研究所内分泌科,邮政编码510080 [2]中山医科大学附属第一医院内分泌科

出　　处：《中国糖尿病杂志》2002年第1期18-21,共4页Chinese Journal of Diabetes

摘　　要：目的　探讨同型半胱氨酸 (Homocysteine,Hcy)与 2型糖尿病病人合并早期糖尿病肾病的关系。方法　应用高效液相色谱分析法测定 6 7例 2型糖尿病病人和 4 7例正常人的血浆 Hcy水平 ,并同步检测可溶性血栓调节蛋白(s TM)、叶酸和维生素 B1 2 。结果　 2型糖尿病病人血浆 Hcy水平明显高于对照人群 (15 .2 7± 6 .0 4 μmol/L vs12 .10± 1.86 μmol/L;P<0 .0 1) ,而合并早期糖尿病肾病的血浆 Hcy水平又高于无糖尿病肾病患者 (17.86± 8.0 4 μmol/L vs13.83± 4 .0 0 μmol/L;P<0 .0 1) ;存在高 Hcy血症的糖尿病病人 ,其早期糖尿病肾病发生率明显高于无高 Hcy血症患者(5 2 .0 % vs2 6 .2 % ;P<0 .0 5 ) ,且前者存在着较高水平的 s TM(P<0 .0 5 )。结论　高 Hcy血症与 2型糖尿病早期肾病的发病有关 。Objective To investigate the relationship between Homocysteine (Hcy) and incipient diabetic nephropathy in type 2 diabetes mellitus (DM).Methods The plasma Hcy level was measured by high performance liquid chromatography with fluorescence detection in 67 patients with type 2 DM and 47 control persons,the plasma thrombomodulin(sTM),folate and vitamin B 12 were determined simultaneously.Results The plasma Hcy level was higher in type 2 DM patients than that in control subjects (15.27±6.04μmol/L vs 12.10±1.86μmol/L, P <0.01),and the plasma Hcy level was higher in incipient diabetic nephropathy patients than that in non nephropathy patients (17.86± 8.04 μmol/L vs 13.83±4.00μmol/L, P <0.01).Diabetic patients with hyperhomocysteinmia had a higher diabetic nephropathy incidence rate (52.0% vs 26.2% P <0.05) compared with noe hyperhomocysteinmia patients,and the former had higher sTM level than the latter ( P <0.05).Through the Logistic regression analysis,it was concluded that Hcy was related to the occurrence of incipient diabetic nephropathy.Conclusion Hyperhomocysteinemia is related to the occurrence of incipient diabetic nephropathy,and endothelial dysfuntion may be involved in its pathogenesis.

关 键 词：同型半胱氨酸 血栓调节蛋白 糖尿病肾病 维生素B12 

分 类 号：R587.1[医药卫生—内分泌]