2型糖尿病肾病患者同型半胱氨酸的变化及相关性研究

Determination of serum homocysteine in type 2 diabetes and evaluate its clinical significance

[目的]本文通过检测2型糖尿病(T2DM)患者血中同型半胱氨酸(HCY)水平,比较各阶段糖尿病肾病患者血中同型半胱氨酸的差异,从而探讨这一指标对2型糖尿病患者肾脏损伤的早期发现、损伤严重程度以及病情监测的应用价值。[方法]将120例2型糖尿病患者根据24 h尿清蛋白排泄量水平分为单纯糖尿病组(SDM组)、早期糖尿病肾病组(IDN组)和临床糖尿病肾病组(CDN组)。并以40名健康者作为对照组,测定血清同型半胱氨酸(HCY)水平。[结果]2型糖尿病组血清HCY水平明显高于对照组,随着病情的发展,IDN组HCY浓度(20.31±7.43)μmol/L,明显高于SDM组(17.33±5.05)μmol/L(P<0.05),CDN组HCY浓度(25.38±8.97)μmol/L又明显高于IDN组(20.31±7.43)μmol/L(P<0.05)。[结论]高同型半胱氨酸浓度是2型糖尿病肾病的一个独立危险因素,测定糖尿病患者血清HCY水平有助于判断和监测2型糖尿病肾病的发生和发展,血清HCY水平随着UAER的增加而升高。

[Objective] To determine the levels of serum homocysteine（HCY） in type 2 diabetes（T2DM）,and find the difference of levels of HCY among each stage of type 2 diabetes nephropathy（T2DN） so that we can find whether HCY can play an important role on the early finding of T2DN.And then evaluate the significance of HCY.[Methods] To choose 120 cases of type 2 diabetes mellitus patients which were divided into three groups according to urea micro protein were called the group of simple diabetic mellitus（SDM group）,incipient diabetic nephropathy（IDN group）,and clinical diabetic nephropathy（CDN group）.And 40 normal persons were regarded as control group.[Results] The levels of HCY in IDN（20.31±7.43）μmol/L were significantly higher than those of SDM（17.33±5.05）μmol/L.And the levels of HCY in CDN（25.38±8.97）μmol/L were significantly higher than those of IDN（20.31±7.43）μmol/L.[Conclusions] The hyperhomocystinemia is an important risk factor of T2DN.Determination of the serum HCY level could be beneficial to clinical evaluation of the occurrence and development of T2DN.