血清同型半胱氨酸和2型糖尿病动脉粥样硬化的关系研究  

Study on the Relationship Between Serum Homocysteine and Atherosclerosis in Type 2 Diabetes Mellitus

作　　者：朱丹 温蔚 何欢 邵志栋 ZHU Dan;WEN Wei;HE Huan;SHAO Zhi-dong(Changshu Meili People's Hospital,Changshu,Jiangsu,215500,China)

机构地区：[1]江苏省常熟市梅李人民医院检验科,江苏常熟215500

出　　处：《中国血液流变学杂志》2023年第2期285-290,共6页Chinese Journal of Hemorheology

摘　　要：目的探讨同型半胱氨酸(homocysteine,Hcy)水平和2型糖尿病(type 2 diabetes,T2DM)动脉粥样硬化(atherosclerosis,AS)的相关性。方法将临床收集的56例T2DM患者按照有无合并AS病变分为AS组31例,非AS组25例;非AS组采用弗雷明汉风险评分(Framingham risk score,FRS)评价10年心血管疾病(CVD)的发病风险,分为低风险组10例(10年患病风险<10%)和风险组15例(10年患病风险≥10%)。分别检测Hcy、血脂等相关指标。采用Pearson相关分析探讨Hcy与其他指标的相关性,采用Logistic多元回归分析研究影响T2DM患者AS病变的危险因素。结果AS组患者血清Hcy水平显著高于非AS组(P<0.05)及对照组(P<0.01)。Pearson相关分析结果显示:收缩压、TG、UA与血清Hcy显著正相关(r=0.63,0.60,0.51,P<0.01);Hcy与BMI、FINS、HOMA-IR、LDL-C、apoB呈正相关(r=0.28,0.36,0.20,0.39,0.38,P<0.05)。风险组Hcy、LDL-C、TG、HbA1c水平均高于低风险组(P<0.01,P<0.05)。Logistic多元回归分析显示T2DM发生AS病变的主要影响因素有Hcy、年龄、收缩压、LDL-C(P<0.01,P<0.05)。结论T2DM患者血清Hcy水平与AS显著相关,AS人群Hcy水平显著高于非AS人群,并且非AS人群中Hcy水平较高者10年CVD的发病风险显著增加,测定血清Hcy水平对AS的防治、风险评估和疗效监测具有重要意义。Objective To explore the correlation between homocysteine(Hcy)level and atherosclerosis(AS)in type 2 diabetes(T2DM).Methods 56 T2DM patients were divided into AS group of 31 cases and non-AS group of 25 cases based on the presence or absence of concomitant AS lesions.The non-AS group used Framingham risk score(FRS)to evaluate the 10-year risk of cardiovascular disease(CVD),divided into a low risk group of 10 cases(10-year risk<10%)and a risk group of 15 cases(10-year risk≥10%)to detect Hcy,blood lipids and other related indicators separately.Pearson correlation analysis was used to explore the correlation between Hcy and other indicators.Logistic multiple regression analysis was used to study the risk factors affecting the AS lesions in T2DM patients.Results Serum Hcy levels in the AS group were significantly higher than those in the non-AS group(P<0.05)and the control group(P<0.01).Pearson correlation analysis showed that systolic blood pressure,TG,and UA were significantly correlated with serum Hcy(r=0.63,0.60,0.51,P<0.01).It is positively correlated with BMI,FINS,HOMA-IR,LDL-C,and apoB(r=0.28,0.36,0.20,0.39,0.38,P<0.05).The levels of Hcy,LDL-C,TG,and HbA1c in the risk group were higher than those in the low-risk group(P<0.01,P<0.05).Logistic multiple regression analysis showed that the main influencing factors for AS lesions in T2DM were Hcy,age,systolic blood pressure,and LDL-C(P<0.01,P<0.05).Conclusion Serum Hcy levels in T2DM patients are significantly correlated with AS,and the Hcy levels in the AS population are significantly higher than those in the non-AS population.Additionally,those with higher Hcy levels in the non-AS population have a significantly increased 10-year risk of CVD.Measuring serum Hcy levels is of great significance for the prevention and treatment,risk assessment,and efficacy monitoring of AS.

关 键 词：同型半胱氨酸 2型糖尿病 动脉粥样硬化 

分 类 号：R446.11[医药卫生—诊断学] R587.1[医药卫生—临床医学]