血浆同型半胱氨酸浓度与2型糖尿病微血管并发症关系探讨

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1、维普资讯http://www.cqvip.com740TianiinMedJ，Dee2OO4，Vd32No12血浆同型半胱氨酸浓度与2型糖尿病微血管并发症关系探讨卜瑞芳邓振霞顾敏峰许岚蒋艳敏沈泓王润洁华嘉临张稷摘要目的：探讨空腹血浆总同型半胱氨酸(tHey)水平与2型糖尿病(DM)微血管病变的关系及其影响因素。方法：108例2型DM患者和45例正常对照者(c组)，DM组分为无并发症组(NDC组)、视网膜病变组(DR组)和肾病组(DN组)，酶免疫分析法测定血浆tHey浓度；发光免疫法测定血清叶酸(FA)和VitB．：水平。结

2、果：DR组和DN组的空腹血浆tHcy浓度明显高于NDC组和c组(P<0．01)；高Hcy血症的DM患者DN、DR发生率明显高于无高HcY血症DM患者(P<0．01)；VitBFA、和血清肌酐(Scr)、餐后2h血糖(2hPBG)均为DM患者they的决定因素(均P<0．01)；Logistic回归分析显示空腹tHey、体质量指数(BMI)、胆固醇(1、C)、FA、VitBl2与DN的发生有关；空腹tHcy、2hPBG、tlE、Scr均为DR的独立危险因素。结论：空腹高tHcy血症是糖尿病微血管病变的危险因素；血清VitBF

3、A、Scr以及代谢紊乱程度影响tHcy的浓度。关键词半胱氨酸2型糖尿病糖尿病肾病糖尿病视网膜病变Relationshipbetweenplasmahomocysteineandmicroangiopathyintype2diabetesmelitusBURuifang，DENGZhenxia，GUMinfeng，XULan，JIANGYanminSHENHong，WangRunjie，HUAJialin，ZHANGJiDa,anm~ofEndocrinology，WUXIFirstHospital，舰Su214002，Ch

4、inaAl：~'tractObjectS：Toinvestigatethemlatiom~pbetweentotalfastingplasmahomocysleine(tHey)andmicroangiopathyintype2diabetesmeUitus(DM)andexplorethefactorsinflue~ingpl~matheyincasesofDM．Ie寸10ds：Onehundredandeightcas．oftype2DMand45casesofnormalcontrol(C)wereenroledin

5、thestuay．Thecasesoftype2DMweredividedintothreegroups：onegroupwithoutcomplications(NDC)、onegroupcomplicatedwithretinopathy(DR)andanothergroupwithnepIm)pa岫(DN)．elflslnatHeywasmeasuredbyEnzymeTransactionImmunoassayand8er1．1lflfolicacid(FA)andVitBl2byfluorescentimlnu．

6、noossay．Results：TheConcentrationoffastingplasmatHeywassignificantlyhlgh~rinDRandDNgroupsthanth0seinNDCandCgroups(P<0．01)；type2DMwithhyperhomocysteinemia(HHcy)hadasignitleanflyhigherincidencerateofDNandDRthanthosewithoutHHcy(P<0．01)．VitBI1、8erulnFA、andcreatine(Cr)、

7、postprandiaF2h-glucose(2hPBG)werealltheinfluentialfactorsforplasmatHeyofDMpatients(P<0．O1)．MultiplelogisticregressionanalysisshowedthatfasthintHeykayweightilldex(BMI)、totalcholesterol(TC)、8erlllnFAandVitBl2wereassociatedwithDN．FastingtHey、2hPBG、T℃、andScrweretheind

8、e．pendentriskfactorsforDRintype2DM．Conclusion：HighfastingplasmaHeyisariskfactorformicroangiopathyintype2DM．SerumFA、VitBl2、Scrandmetabolicdisordermayinfl