2型糖尿病肾病患者血脂和同型半胱氨酸的变化及其相关性研究

Clinical significance of determination of blood lipid levels and serum homocysteinemia levels in patients with type 2 diabetic nephropathy

目的探讨血脂和同型半胱氨酸（HCY）在2型糖尿病肾病（T2DN）中的变化，并探讨其与尿白蛋白排泄率（UAER）之间的关系。方法根据尿UAER将169例2型糖尿病（T2DM）患者分为单纯糖尿病组（SDM组）、早期糖尿病肾病组（EDN组）和临床糖尿病肾病组（CDN组），45例体检健康者作为健康对照组，分别测定血脂及HCY水平。结果与健康对照组比较，T2DM3组患者血脂、HCY的差异有统计学意义（P〈O．05）；与SDM组比较，EDN组和CDN组Lp（a）、HCY的差异有统计学意义（P〈0．05）；与EDN组比较，CDN组Lp（a）、HCY的差异有统计学意义（P〈0．05）。Lp（a）和HCY分别与UAER呈正相关（r分别为0．496、0．502，P〈0．05）。结论血清HCY及Lp（a）水平随着UAER的增加而升高，两者与UAER之间关系密切，可能与糖尿病肾病的进展有关。

Objective To study the changes of blood lipid levels and serum homocysteinemia （HCY） levels and to investigate their relationship with urinary albumin excretion rate （UAER） in patients with type 2 diabetic nephropathy （T2DN）. Methods According to the result of UAER, 169 patients with type 2 diabetes mellitus （T2DM） were divided into simple diabetes mellitus（SDM）, early diabetic nephropathy（EDN） group and clinical diabetic nephropathy（CDN） group, and 45 healthy people were employed as controls. The levels of blood lipid and serum HCY of all groups were examined. Results There were significantly statistical difference of blood lipid and HCY levels in three T2DM groups as compared with that of control group （P〈0.05）. Lp（a） and HCY levels in EDN and CDN groups were significantly higher than those in SDM group （P〈0.05）, and Lp（a） and HCY levels in CDN group were significantly higher than those in EDN group （P〈0.05）. Lp（a） and HCY were positively correlated with UAER （r=0.496, 0. 502 respectively,P〈0.05）. Conclusion The levels of serum Lp（a） and HCY in DN were increased with the increment of UAER, and they had a close rela- tionship with UAER. Increment of Lp（a） and HCY might be associated with the progression of DN.