B族维生素水平与2型糖尿病患者肾病进展的关系  

Association between B Vitamins levels and progression of diabetic nephropathy

作　　者：姚云[1] 吴萍[1] 陈莹[2] 罗斌[1] 王加勇[3] YAO Yun;WU Ping;CHEN Ying;LUO Bin;WANG Jia yong(Dept.of Clinical Nutrition,Tongji Hospital,Tongji University,Shanghai 200065,China;Dept.of Gastroenterology,Tongji Hospital,Tongji University,Shanghai 200065,China;Clinical Laboratory,Tongji Hospital,Tongji University,Shanghai 200065,China)

机构地区：[1]同济大学附属同济医院临床营养科,上海200065 [2]同济大学附属同济医院消化科,上海200065 [3]同济大学附属同济医院检验科,上海200065

出　　处：《同济大学学报（医学版）》2018年第5期66-70,共5页Journal of Tongji University(Medical Science)

基　　金：国家自然科学基金(81502041)

摘　　要：目的探讨B族维生素在2型糖尿病(diabetes mellitus,type 2,T2DM)患者血浆中的水平差异并分析其与糖尿病肾病(diabetic nephropathy,DN)进展的关联性。方法选取2017年1月—2017年8月同济大学附属同济医院诊断为T2DM的住院患者209例,根据肾小球滤过率(glomerular filtration rate,GFR)和尿微量白蛋白的排泄率(urinary albumin excretion rates,UAER)将209例患者分为糖尿病无肾病组(n=99)、糖尿病轻度肾病组(n=70)和糖尿病中重度肾病组(n=40)。比较3组患者的维生素B_1(VitB_1)、维生素B_2(VitB_2)、维生素B_6(VitB_6)、叶酸(VitB_9)、维生素B_(12)(VitB_(12))及其他临床生化指标的含量,并进行相关性分析。结果 3组T2DM患者的白蛋白(albumin,ALB)、VitB_6、VitB_9、VitB_(12)水平随肾脏病变程度的加重而降低,差异有统计学意义(P<0. 05),同型半胱氨酸(homocysteine,Hcy)水平随肾脏病变程度的加重而升高,差异有统计学意义(P<0. 05); 3组T2DM患者的ALB水平与VitB_9、VitB_(12)水平均呈正相关关系(r=0. 198,P<0. 05; r=0. 205,P<0. 05),Hcy水平与VitB_9、VitB_(12)水平呈负相关关系(r=-0. 414,P<0. 001; r=-0. 276,P<0. 05); VitB_2水平与腰臀比(waist-tohip ratio,WHR)水平呈正相关关系(r=0. 150,P<0. 05)。结论 Hcy、VitB9及VitB_(12)水平与T2DM患者的肾病进展密切相关,监测糖尿病患者的Hcy、VitB_9及VitB_(12)的含量有助于临床预测、判断DN的进展。Objective To investigate the association between plasma levels of B vitamins and the progression of diabetic nephropathy（DN） in patients with type 2 diabetes mellitus（T2DM）.Methods Two hundred and nice patients with T2DM admitted in Tongji Hospital between January 2017 and August 2017 were enrolled in the study. According to the glomerular filtration rate（GFR） and urinary albumin excretion, patients were divided into non-DN group（ n =99）, mild DN group（ n =70） and moderate to severe DN group（ n =40）. The plasma levels of vitamin B 1（VitB 1）, Vitamin B 2（VitB 2）, Vitamin B 6（VitB 6）, Vitamin B 12 （VitB 12 ） and other clinical biochemical indexes were analyzed and compared among three groups.Results The levels of albumin（ALB）, VitB 6, VitB 9 and VitB 12 in T2DM patients were decreased and the homocysteine（Hcy） levels were increased with the severity of renal lesions（all P 〈0.05）. The ALB level was a positively correlated with the levels of VitB 9 and VitB 12 in T2DM patients（ r =0.198, P 〈0.05; r =0.205, P 〈0.05）. The Hcy level was negatively correlated with VitB 9 and VitB 12 levels（ r =-0.414, P 〈0.001 and r =-0.276, P 〈0.05）. There was a positive correlation between VitB 2 level and waist-to-hip ratio（WHR）（ r =0.150, P 〈0.05）.Conclusion The levels of Hcy, VitB 9 and VitB 12 in patients with diabetes mellitus are closely correlated with the progression of nephropathy in T2DM patients.

关 键 词：2型糖尿病 糖尿病肾病 B族维生素 营养状况 

分 类 号：R587[医药卫生—内分泌]