甲钴胺对T2DM患者血Hcy水平和尿MCP-1、TGF-β1排泄的影响  

The effect of mecobalamine treatment on serum Hcy and urinary MCP-1,TGF-β1 excretion in type 2 diabetics

作　　者：鲍溪荷[1] 徐将[1] 叶山东[1] 杨春林 

机构地区：[1]安徽医科大学附属省立医院内分泌科,安徽合肥230001 [2]安徽医科大学附属省立医院生物化学实验室,安徽合肥230001

出　　处：《中华疾病控制杂志》2014年第11期1095-1098,共4页Chinese Journal of Disease Control & Prevention

基　　金：安徽省自然科学基金(11040606M159);安徽高校省级自然科学研究(KJ2011A157)

摘　　要：目的观察甲钴胺对2型糖尿病(type 2 diabetes mellitus,T2DM)患者血同型半胱氨酸(serum homocysteine,s Hcy)和尿单核细胞趋化蛋白-1(monocyte chemoattractant protein-1,MCP-1)、转化生长因子-β1(transforming growth factor-β1,TGF-β1)排泄的影响,探讨其肾脏保护的可能机制。方法 33例T2DM患者在原糖尿病治疗方案的基础上联合甲钴胺(甲钴胺治疗组,DE组),观察6个月,比较治疗前后空腹血糖(fasting plasma glucose,FPG)、糖化血红蛋白(haemoglobin A1c,Hb A1c)、s Hcy水平及尿MCP-1、TGF-β1及尿白蛋白(albumin,ALB)排泄的变化。结果基础状态时,DE组FPG、Hb A1c、s Hcy及尿白蛋白肌酐逼(urinary albumin to creatinine ratio,UACR)、尿单核细胞趋化蛋白-1肌酐比(urine MCP-1 to creatinine ratio,UMCR)、尿转化生长因子-β1肌酐比(urine TGF-β1 to creatinine ratio,UTCR)水平均高于NC组(均有P<0.05);与治疗前比较,DE组治疗后FPG、Hb A1c无明显变化,s Hcy、UMCR、UTCR及UACR下降(均有P<0.05);T2DM患者UMCR,UTCR分别与UACR的呈正相关(r1=0.611,P1<0.001;r2=0.635,P2<0.001);s Hcy与UACR、UTCR和UMCR呈正相关(r1=0.634,P1<0.001;r2=0.507,P2<0.001;r3=0.433,P3<0.001)。结论甲钴胺可以降低T2DM患者体内增强的炎症反应,该作用可能与其肾脏保护有关。Objective To observe the effect of mecobalamine on serum homocysteine（ s Hcy） and urinary monocyte chemokine protein-1（ MCP-1）,transforming growth factor-β1（ TGF-β1） in type 2 diabetics and explore its possible renoprotective mechanisms. Methods Mecobalamine was given to 33 type 2 diabetic patients（ Group DE） on the basis of anti-diabetes treatment for 6 months,and FBP,Hb A1 c,Hcy and urinary albumin to creatinine ratio（ UACR）,urine monocyte chemokine protein-1 to creatinine ratio（ UMCR）,urine tumor necrosis factor-α to creatinine ratio（ UTCR） levels were determined respectively at the basal and 6th month of the measurement. Results Compared to group NC,fasting plasma glucose（ FPG）,haemoglobin A1c（ Hb A1c）,s Hcy and UACR,UMCR,UTCR levels increased significantly at the baseline（ all P〈0. 05）. Compared with pre-treatment,s Hcy and UACR,UMCR,UTCR levels were all distinctly decreased（ P〈0. 05）,but no obvious changes were seen in FPG and Hb A1c（ all P〉0. 05）. UMCR and UTCR were positively associated with UACR,respectively（ r1= 0. 611,P〈1 0. 001; r2= 0. 635,P2〈 0. 001）. The s Hcy had positively correlation with UACR,UMCR and UTCR levels in group DE（ r1= 0. 634,P1〈 0. 001; r2= 0. 507,P2 〈0. 001; r3= 0. 433,P3 〈0. 001）,respectively. Conclusions Mecobalamine can ameliorate the enhanced inflammation reaction in vivo of type 2 diabetics,which may contribute to its renoprotection partly.

关 键 词：糖尿病肾病 转化生长因子 半胱氨酸 

分 类 号：R587.1[医药卫生—内分泌]