摘要
目的:评估空腹血浆总同型半胱氨酸(tHcy)水平与2型糖尿病(DM)周围神经病变的关系,并分析影响DM患者血浆tHcy水平的因素。方法:以103例2型糖尿病患者为DM组,45例健康者为正常对照组,其中DM组分为有周围神经病变组(DPN+组)和无周围神经病变组(DPN-组),用酶转换免疫分析法测定血浆tHcy浓度;并用发光免疫法测定血清叶酸和维生素B12水平。结果:DPN+组的空腹血浆tHcy浓度明显高于DPN-组和正常对照组[(14.20±2.92)μmol/Lvs(9.05±1.78)μmol/L和(8.95±2.27)μmol/L,P<0.01];存在高Hcy血症的DM患者DPN发生率明显高于无高Hcy血症患者(80.65%vs34.72%,P<0.01)。逐步回归分析显示:维生素B12、叶酸(FA)均为DM患者tHcy的决定因素(P<0.01);多元Logistic回归分析显示,空腹tHcy、糖化血红蛋白(HbA1C)、维生素B12均与DPN的发生有关;空腹血浆tHcy、HbA1C、V itB12均为DPN的独立危险因素。结论:空腹高Hcy血症是DPN的危险因素;血清维生素B12、FA水平影响tHcy的浓度。
Objective： To investigate the relationship between total fasting plasma homocysteine（tHcy） and peripheral neuropathy in type 2 diabetes mellitus （DM） and explore the factors influencing plasma tHcy in cases of DM. Methods ：103 cases of type 2 DM and 45 cases of normal control（C） were enrolled in the study. The cases of type 2 DM were divided into two groups：one group with diabetes peripheral neuropathy （DPN＋） ,and one group without diabetes peripheral neuropathy（DPN-）. Plasma tHcy was measured by Enzyme Transaction Immunoassay and serum FA and VitB12 by fluorescent immunoassay. Results ： The concentration of fasting plasma tHcy was significantly higher in DPN＋group than that in DPN-group and group C [（14.20±2.92 ）μmol/L vs （9.05±1.78 ）μmol/L, （8.95±2.27 ）μmol/L,P 〈 0.01 ] . Type 2 DM With hyperhomocysteinemia （HHcy） had a significantly higher incidence rate of DPN than those without HHcy（80.65% vs 34.72% ;P 〈0.01 ）. Multiple stepwise regression analysis revealed VitB12 and serum FA both were the influential factors for plasma tHcy of DM patients （P〈0.01 ）. Multiple Logistic regression analysis showed HbA1C and VitB12 were similar to fasting tHcy associated with DPN. Fasting tHcy, HbA1C and VitB12 were the independent risk factors for DPN in type 2 DM. Conclusion： High fasting plasma Hcy is a risk factor for peripheral neuropathy in type 2 DM. Serum FA and VitB12 may influence the plasma tHcy level.
出处
《医学研究生学报》
CAS
2005年第12期1113-1115,1119,共4页
Journal of Medical Postgraduates
