血清中同型半胱氨酸与2型糖尿病血管病变的关系分析  

Analysis of the correlation between serum homocysteine level and vasculopathy of type 2 diabetes mellitus

作　　者：贾新菊[1] 董闪闪[1] 康岩[1] 刘莉 王丽娜[1] JIA Xin-ju;DONG Shan-shan;KANG Yan;LIU Li;WANG Li-na(Department of Endocrinology, the First Hospital of Hebei Medical University, Shijiazhuang 050031, China)

机构地区：[1]河北医科大学第一医院内分泌科,河北石家庄050031

出　　处：《河北医科大学学报》2020年第4期396-400,共5页Journal of Hebei Medical University

基　　金：河北省医学科学研究重点课题(20170505)。

摘　　要：目的分析血清同型半胱氨酸(homocysteine acid,Hcy)水平与2型糖尿病(type 2 diabetes mellitus,T2DM)血管病变的关系。方法选取T2DM患者51例、T2DM合并血管病变患者50例和健康体检者59例。记录所有研究对象性别、年龄、吸烟、体重指数(body mass index,BMI)、血压、血清Hcy、三酰甘油(triglyceride,TG)、胆固醇(total cholesterol,TC)、尿素氮(urea nitrogen,BUN)、肌酐(creatinine,Cr)等。根据Hcy水平将研究对象分为正常Hcy组和高Hcy组,分析血清Hcy水平与T2DM血管病变的关系和高Hcy形成的影响因素,并分析T2DM血管病变相关危险性因素。结果T2DM组和血管病变组TG、TC、Hcy显著高于对照组,血管病变组Hcy高于T2DM组(P<0.01);血管病变组Cr显著高于对照组和T2DM组(P<0.01)。以Hcy>15μmol/L为Hcy升高标准,T2DM组和血管病变组血清Hcy升高发生率明显高于对照组(P<0.01)。高Hcy组中空腹血糖(fasting plasma glucose,FPG)、糖化血红蛋白(glycosylated haemoglobin A1c,GHbA1c)、BUN、TC、TG、Hcy以及血管病变发生率显著高于正常Hcy组(P<0.01)。相关性分析结果显示,Hcy与FPG、GHbA1c、BUN、Cr、TC、TG呈正相关(P<0.01)。多元逐步Logistic回归分析,结果显示,TC和Hcy是糖尿病血管病变的影响因素(P<0.05)。结论血清Hcy可能参与T2DM血管病变的发生,是T2DM血管病变的危险因素。Objective To analyze the relationship between serum homocysteine(Hcy)and vascular disease in type 2 diabetes mellitus(T2DM).Methods Clinical data were collected from 160 participants.Three groups were divided according to type of complication:group I of T2DM with no complications,51 cases(T2DM group),groupⅡof T2DM with vascular complications(macrovascular disease group),and another 59 normal people without T2DM was randomly as control group.All the detailed information(sex,age,smoking,body mass index(BMI),blood pressure)was recorded in the patient record,and the levels of a series index such as,Hcy,triglyceride(TG),total cholesterol(TC),urea nitrogen(BUN),creatinine(Cr)were measured and compared between the three groups.Then the subjects were divided into the normal Hcy group and the high Hcy group according to the serum Hcy level.The relationship between the serum Hcy level and the incidence of T2DM vascular lesions was analyzed,the influencing factors for the formation of high Hcy and the risk factors related to T2DM vascular lesions were analyzed.Results The levels of TG,TC,and Hcy in T2DM and macrovascular disease group were significantly higher than in control group(P<0.01).Hcy in macrovascular disease group were higher than in T2DM group(P<0.01),and Cr in macrovascular disease group was higher than in T2DM and control group(P<0.01).With Hcy>15μmol/L as the hyperhomocysteinemia(HHcy),the incidence of HHcy in T2DM and macrovascular disease group were significantly higher than in the control group(P<0.01).The incidence of high level of fasting plasma glucose(FPG),glycosylated haemoglobin A1c(GHbA1c),BUN,TC,TG,Hcy and vascular lesions in HHcy group were significantly higher than in normal Hcy group(P<0.05).Correlation analysis results showed that Hcy had positive correlation with FPG,GHbA1c,BUN,Cr,TC and TG.Analysis of T2DM related risk factors with Logistic regression analysis showed that TC was an independent risk factor of T2DM with vascular complications.Conclusion Hcy may be involved in the development

关 键 词：血清同型半胱氨酸 糖尿病 2型 血管病变 

分 类 号：R735.7[医药卫生—肿瘤]