不同胰岛素抵抗状态的老年女性2型糖尿病患者血清同型半胱氨酸水平的研究

Serum homocysteine level in old female type 2 diabetic patients with different insulin resistance

目的探讨不同胰岛素抵抗状态的老年女性2型糖尿病(T2DM)患者血清同型半胱氨酸(tHcy)水平的变化。方法对50例老年女性T2DM患者分别测定身高、体重、腰围、臀围、血压、血清总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、血糖、血胰岛素、tHcy和肿瘤坏死因子-α(TNF-α);计算体重指数(BMI)、腰臀比(WHR);根据胰岛素抵抗指数(IRI),50例患者被分为两组,胰岛素抵抗较重组(IR-H,28例,IRI>3)和胰岛素抵抗较轻组(IR-L,22例,IRI≤3)。结果IR-H组患者的HDL-C显著低于IR-L组,IR-H组患者的TC、TG、收缩压(SBP)、舒张压(DBP)、WHR、BMI、TNF-α和tHcy均显著高于IR-L组,差异有统计学显著意义,而两组之间的血糖、年龄没有统计学差异,血tHcy与BMI、WHR、IRI、TNF-α、SBP、DBP呈正相关,与HDL-C呈负相关。结论研究显示,IR较重的T2DM患者的血清tHcy显著高于IR较轻的T2DM患者。tHcy可能和其它心血管危险因素如肥胖、高血压、高血脂等一起促进冠心病的发生发展。

Objective To investigate the changes of serum homocysteine（tHcy） level in old female diabetic patients with different insulin resistance（IR）. Methods All enrolled patients underwent the following examinationst biochemical cardiovascular risk factors including TC, TG, HDL-C,glucose, insulin, tHcy and turnout necrosis factor-α （TNF-α）. The fat mass was assessed by BMI and retio of waist to hip circumference（WHR）. The patients were derided into two groups according to IR index（IR-H group ： IRI〉3, IR-L group ： IRI≤3）. Results The serum TC,TG,TNF-α and tHcy of IR-H group were significantly higher than those of IR-L group . Also, the SBP,DBP, BMI and WHR of IR-H group were significantly higher than those of IR-L group. No statistical differences were detected in the age and blood glucose between the 2 groups, tHcy was positively correlated with BMI,WHR,IRI,TNF- α,SBP and DBP,and was negatively correlated with HDL-C. Conclusions The present study shows that the serum tHcy level in old female type-2 diabetic patients with heavy IR is significantly higher than that in old female type-2 diabetic patients with low IR. tHcy together with other cardiovascular risk factors may promote the development of coronary heart disease.