老年2型糖尿病患者高同型半胱氨酸血症与胰岛素抵抗相关研究

Investigation on Hcy and Insulin for 86 Elder Cases with Type 2 Diabete

目的:探讨老年2型糖尿病患者同型半胱氨酸(Hcy)与胰岛素抵抗的相关性,分析高同型半胱氨酸血症(HHcy)的影响因素。方法:选取30例老年体检者作为健康对照组,同时选取符合入选标准的86例老年2型糖尿病患者按照体重指数分为正常体重组、超重组和肥胖组。留取血、尿测定Hcy及生化指标,计算体重指数(BMI)、稳态模型胰岛素抵抗指数(HOMA-IR)。结果:1.各组血浆Hcy水平依次升高,F=20.134,P=0.000。2.各组间HOMA-IR、BMI、FPG、FINS、HbA1c、TC、TG、HDL-c、LDL-c、尿Alb/Cr、BUN、收缩压(SBP)、病程有统计学差异,P<0.05。Cr、舒张压(DBP)无差别,P>0.05。3.相关分析表明Hcy与HOMA-IR、BMI、FPG、HbA1c、TC、TG、HDL-c、LDL-c、尿Alb/Cr、Cr、SBP、DBP、病程成显著正相关,P<0.05;与BUN、FINS无相关性,P>0.05。进一步多元线性逐步回归分析显示仅HOMA-IR、BMI、SBP、TC、尿Alb/Cr、Cr、FPG与血浆Hcy水平独立相关。结论:1.随着胰岛素抵抗的加重,血浆Hcy水平逐渐升高。老年2型糖尿病患者血浆Hcy水平升高与胰岛素抵抗有关。2.老年2型糖尿病患者HOMA-IR、BMI、SBP、TC、尿Alb/Cr、Cr、FPG是影响血浆Hcy水平的独立相关因素。

Objective：To study the relationship between insulin resistance and homocysteine（Hcy） for the elder patients with type 2 diabetes mellitus, and analyze the same type of high Hyper- homoeysteinemia （HHcy） risk factors. Methods：30 cases selected from the elders were tavea as a healthy control group,86 elder cases with type 2 diabetes mellitus were divided into normal weight, overweight and super-obesity group according to body mass index（BMI）. Hematuria was collected with Hcy levels and other indicators, BMI and steady-state model insulin resistance index were calculated （HOMA-IR）. Results： 1. The level of Hcy for each group increased in turn （F = 20. 134, P = 0. 000）. 2. HOMAIR, BMI, FPG, FINS, HbAlc, TC, TG, HDL-c, LDL-c, urine Alb/Cr, BUN, systolic blood pressure （SBP）, duration differences were statistically significant （P〈0.05）. And Cr,diastolic blood pressure （DBP） were non-discriminatory, P：〉0.05.3. The correlation analysis showed that Hcy and HOMA-IR, BMI, FPG, HbAlc, TC, TG, HDL-c, LDL-c, urine Alb/Cr, Cr, SBP, DBP were significant positive correlations, P〈0.05, but a significant difference to gender, age, BUN, FINS no relevance, P〉0.05. Further stepwise multiple regression analysis indicated that only HOMAIR, BMI, SBP, TC, urine Alb/Cr,Cr, FPG and mellitus Hcy levels independently correlated. Conclusion： 1. With the increased insulin resistance,mellitus Hcy levels gradually increased. Mellitus Hcy levels for elderly type 2 diabetic patients related to insulin resistance. 2. HOMAIR in elder patients with type 2 diabetes mellitus,BMI,SBP,TC, urine Alb/ Cr,Cr,FPG is the impact of Hcy levels of independence relevant factors.