2型糖尿病慢性并发症与血清同型半胱氨酸水平的关系

Relationship between concentration of serum homocysteine and cardio-cerebravascular complications in patients with type 2 diabetes mellitus

目的探讨2型糖尿病慢性并发症与血清同型半胱氨酸水平的关系。方法用化学发光法检测50例2型糖尿病患者及50例正常对照者血清半胱氨酸、叶酸和维生素B12水平。结果糖尿病有并发症组与健康对照组相比,血清同型半胱氨酸水平明显升高(P<0.01),糖尿病无并发症组较正常对照者相比,血清同型半胱氨酸水平明显升高(P<0.01)。高同型半胱氨酸血症组心脑血管并发症发生率较健康对照组明显升高(P<0.05),糖尿病组叶酸水平明显低于健康对照组(P<0.01),糖尿病两亚组相比,差异无统计学意义。糖尿病组和健康对照组叶酸水平与同型半胱氨酸水平呈负相关(糖尿病组r=-0.36,P=0.01;对照组r=-0.41,P=0.02)。维生素B12水平糖尿病组与健康对照组相比差异无统计学意义(P>0.05),糖尿病两亚组相比差异无统计学意义(P>0.05)。糖尿病组和健康对照组维生素B12水平与同型半胱氨酸水平均无明显相关性(糖尿病组r=-0.20,P=0.14对照组r=-0.31,P=0.18)。结论高同型半胱氨酸血症易诱发2型糖尿病患者慢性并发症的发生,早期给予叶酸及B族维生素可能对预防慢性并发症的发生有益。

Objective To investigate the relationship between the concentration of serum homocysteine （Hey） and cardio-cerebravascular complication in patients with type 2 diabetes mellitus （DM）. Methods Fifty patients with type 2 DM and fifty normal controls were involved in this study. The serum Hcy,folic acid and the level of vitamin B12 were examined by the chemiluminescence technique. Results The concentration of serum Hcy was significantly higher in type 2 DM with or without cardio-cerebrovascular complications than that in the control group （ P 〈 0. 01 ）, diabetic patients with hyperhomocysteinmia had a higher incidence of cardio-cerebravascular complications compared with the control group （P 〈 0. 05 ）. The level serum of serum folic acid was significantly lower in diabetic group than that in the control group （P 〈 0.01 ）, and the difference about the level of serum folic acid between two diabetic groups was not significant （ P 〉 0.05 ）. The level of serum folic acid was negatively related to that of serum bomocysteine in both diabetic group and control group （ in diabetic group r = - 0.36, P = 0.01, and in control group r = 0. 41 ,P =0.02）. The level of serum vitamin B12 of the diabetic group was not significantly different from that of con- trol group （P 〉 0.05）, and the levels of serum Vitamin B12 in the two diabetic groups were not significantly different. The level of Vitamin B12 and the concentration of homoeysteine were not significantly correlated both in the diabetic group and control group （ in diabetic group r = -0.20,P =0.14,and in control group r = -0.31 ,P =0.18）. Conclusion Hyperhomoeysteinmia may be a risk factor of diabetic chronic complications, so early supplement of folio acid and vitamin B can help to prevent the occurrence of the chronic complications.