同型半胱氨酸与2型糖尿病慢性血管并发症关系的研究

STUDY ON THE RELATIONSHIP BETWEEN HOMOCYSTEINE AND VASCULAR COMPLICATIONS OF TYPE 2 DIABETES

[目的]研究同型半胱氨酸与2型糖尿病(T2DM)大、微血管并发症的关系。[方法]用循环酶法测定68例2型糖尿病患者的血清同型半胱氨酸水平,葡萄糖氧化酶法测定血糖水平,放射免疫法测定C肽、胰岛素水平,全自动生化分析仪测定各项生化指标,并与36例正常对照组作比较。[结果]2型糖尿病患者血清同型半胱氨酸(Hcy)水平明显高于正常对照组(P﹤0.01),2型糖尿病合并血管并发症者高于无血管并发症者。2型糖尿病伴有高同型半胱氨酸血症(hHcy)的患者其并发症明显多于同型半胱氨酸水平正常的患者。2型糖尿病患者血清同型半胱氨酸水平与空腹胰岛素(FINS)、胰岛素分泌指数(HOMA-β)、胰岛素抵抗指数(HOMA-IR)呈负相关(r=-0.362,-0.300,-0.290;P﹤0.05),与糖化血红蛋白(HbA1c)呈正相关(r=0.419;P﹤0.05),)。[结论]同型半胱氨酸水平升高可能是2型糖尿病患者慢性血管并发症发生发展的一个重要相关因素。检测2型糖尿病患者血清同型半胱氨酸水平对于了解患者病情,指导临床治疗具有一定的意义。

[ Objective ] To study the relationship between homocysteine and vascular complications of type 2 diabetes. [ Methods] Serum homoeysteine were identified with eyclophorase method, blood glucose with glueose-oxidase method, Cpeptide with radio-immunity method, insulin with radio-immunity method, biochemical indicators levels with automatic biochemical analysator in 68 patients with type 2 diabetes as well as in 36 controls. [Results] Serum homocysteine levels in the diabetic patients were significantly higher than those in controls （r = 〈 0. 01 ）, and type 2 diabetes with vascular complications were more than who had no vascular complications. The homocysteine levels were negatively conelated with those of fasting blood insulin, insulin resistance index （HOMA-IR） and insulin secretion index （HOMA-β） （r = -0.362, -0.300, -0.290; all P 〈 0.05）, were positively correlated with glyeosylated hemoglobin （r = 0.419; P 〈 0.05）. [Conclusion] The raise of serum homocysteine may be a significant correlation factor on the complications of type 2 diabetes. The detection of serum homocysteine of type 2 diabetes is significant to comprehend the disease condition of patients and guide clinical therapies.