血浆同型半胱氨酸水平与2型糖尿病患者微血管病变的关系分析  

Relationship between plasma homocysteine level and microangiopathy in patients with type 2 diabetes mellitus

作　　者：李玉婷[1] 王嘉欣[1] 吴美巧 李璐瑶 管海飞 樊婷婷 蔡妍 张川[1] LI Yuting;WANG Jia-xin;WU Mei-qiao(The Second Hospital of Jilin University,Changchun 130041,China)

机构地区：[1]吉林大学第二医院内分泌科

出　　处：《中国实验诊断学》2019年第11期1873-1877,共5页Chinese Journal of Laboratory Diagnosis

摘　　要：目的探讨2型糖尿病(T2DM)患者血浆同型半胱氨酸(HCY)水平与微血管病变的关系,为T2DM患者微血管病变的早期诊断提供指导。方法选取本院收治的初诊T2DM患者228例,根据是否伴微血管并发症分为微血管病变组(n=98)和无微血管病变组(n=130)。另选取同期健康体检者100名为对照组。所有对象均进行体格检查及血糖、血脂、肾功能及HCY水平检测(全自动生化分析仪),应用单因素方差分析进行多组间比较,应用LSD-t检验进行组间两两比较,并进行多因素Logistic回归分析及受试者工作特征(ROC)曲线分析。结果与对照组比较,微血管病变组、无微血管病变组收缩压、舒张压、空腹血糖、餐后2h血糖、糖化血红蛋白、总胆固醇、甘油三酯、低密度脂蛋白、尿素氮、血肌酐及HCY水平均明显较高(P<0.05),高密度脂蛋白水平明显较低(P<0.05);与无微血管病变组比较,微血管病变组收缩压、舒张压、糖化血红蛋白、血肌酐及HCY水平均明显较高(P<0.05)。多因素Logistic回归分析,收缩压(OR=2.307,95%CI:1.031-5.163)、糖化血红蛋白(OR=4.464,95% CI:1.577-12.639)、血肌酐(OR=2.502,95% CI:1.094-5.721)及HCY(OR=1.394,95% CI:1.085-1.791)水平均为T2DM患者微血管病变发生的独立危险因素(P<0.05)。ROC曲线分析,血浆HCY水平诊断T2DM患者发生微血管病变的曲线下面积为0.841(95%CI:0.773-0.911)。结论血浆HCY水平是T2DM患者微血管病变的独立危险因素,对T2DM微血管病变的诊断有重要价值。Objective To explore the relationship between plasma homocysteine(HCY)level and microangiopathy in patients with type 2diabetes mellitus(T2DM),and provide guidance for early diagnosis of microangiopathy in patients with T2DM.Methods A total of 228 patients with newly diagnosed T2DM admitted to our hospital from January 2018to December 2018were selected and divided into microangiopathy group(n=98)and non-microangiopathy group(n=130)according to whether they had microvascular complications.Another 100healthy examiners at the same time period were selected as control group.All subjects were given physical examination and detection of blood glucose,blood lipids,renal function and HCY level(automatic biochemical analyzer).One-way ANOVA was used to compare multiple groups.LSD-t test was used to compare any two groups among the groups,and multivariate Logistic regression analysis and receiver operating characteristic(ROC)curve analysis were performed.Results Compared with control group,the systolic blood pressure,diastolic blood pressure,fasting blood glucose,postprandial 2hblood glucose,glycosylated hemoglobin,total cholesterol,triglyceride,low density lipoprotein,urea nitrogen,serum creatinine and HCY were significantly higher in microangiopathy group and non-microangiopathy group(P<0.05)while the high-density lipoprotein level was significantly lower(P<0.05).Compared with non-microangiopathy group,the systolic blood pressure,diastolic blood pressure,glycosylated hemoglobin,serum creatinine and HCY were significantly higher in microangiopathy group(P<0.05).Multivariate Logistic regression analysis showed that systolic blood pressure(OR=2.307,95%CI:1.031-5.163),glycosylated hemoglobin(OR=4.464,95%CI:1.577-12.639),serum creatinine(OR=2.502,95%CI:1.094-5.721)and HCY(OR=1.394,95%CI:1.085-1.791)were independent risk factors for occurrence of microangiopathy in T2DM patients(P<0.05).ROC curve analysis showed that the area under the curve of plasma HCY level was 0.841(95%CI:0.773-0.911)in the diagnosis of microangiopathy in

关 键 词：2型糖尿病 同型半胱氨酸 微血管病变 临床相关性 

分 类 号：R587.1[医药卫生—内分泌]