血同型半胱氨酸与2型糖尿病肾病发病的关系

Relationship between serum homocystine and diabetic nephropathy and uremia in the patients with type 2 diabets mellitus

目的探讨同型半胱氨酸(HCY)与2型糖尿病肾病患者的关系。方法根据糖尿病患者24h尿白蛋白排泄率(UAE)分为三组:无肾病组、早期肾病组和临床蛋白尿组。同时用荧光偏振分析法测定患者总同型半胱氨酸浓度,并常规生化仪监测空腹血糖。结果合并早期肾病组平均HCY与无肾病组比较有明显差异[(26·16±12·31)μmol/L与(8·79±3·51)μmol/L,P<0·01]。临床蛋白尿组HCY虽高于早期肾病,但无统计学意义[(30·15±10·35)μmol/L与(26·16±12·31)μmol/L,P>0·05]。随着蛋白尿的增多而血清同型半胱氨酸也相应增加。结论高HCY可能与糖尿病肾病有关,是患者的独立危险因素。

Objective To explore the relationship between homocystine（HCY） and diabetic nephropathy and uremia in the patients with type 2 diabetes mellitus. Methods 20 cases with type 2-DM,20 cases with incipient diabetic nephropathy and 17 cases with uremia were collected. The plasma levels of HCY were measured by FPIA,the fasting blood sugar were measured by standard automated clinical chemistry laboratory methods. The plasma levels of HCY were compared with each other with t test. Results The plasma levels of HCY between the type 2-DM and diabetic nephropathy were significantly different, （26.16 ± 12.31 ）μmol/L vs （8.79 ±3.51 ）μmol/L, P 〈 0.01. The plasma level of HCY in group of uremia was higher than diabetic nephropathy, but there was no statistical significance,（30.15± 10.35）μmol/L vs （25.82 ±13.65）μmol/L,P〈0.05.Conclusion The significant increase in the plasma level of HCY may be an independent risk factor for incipient diabetic nephropathy.