超敏C反应蛋白及血同型半胱氨酸与2型糖尿病视网膜病变的关系

Correlation of high sensitive C-reactive protein and homocysteine with type 2 diabetes mellitus retinopathy

目的探讨2型糖尿病患者血同型半胱氨酸(homocysteine,Hcy)、超敏C反应蛋白(high sensitive C-reactive protein,hsCRP)水平同糖尿病视网膜病变(diabetic retinopathy,DR)之间的关系。方法将212例2型糖尿病患者分为3组:无糖尿病视网膜病变组(NDR)102例,背景型糖尿病视网膜病变组(BDR)66例,增生性糖尿病视网膜病变组(PDR)44例;分别测定各组间的Hcy和hsCRP水平,并对血脂、空腹胰岛素(FINS)、胰岛素敏感指数(ISI)、病程(HI)、体质量指数(BMI)、总胆固醇(TC)、甘油三酯(TG)、空腹血糖(FBG)、空腹胰岛素(FINS)、胰岛素敏感指数(ISI)等参数进行测定,比较各组参数的差异及DR和Hcy、hsCRP的相关性。结果 BDR组、PDR组hsCRP和Hcy显著高于NDR组(均为P<0.01),PDR组hsCRP、Hcy也高于BDR组(均为P<0.05),DR同hsCRP、Hcy、HI、TC(r值分别为0.615、0.556、0.356、0.252,P值分别为<0.01、<0.01、<0.05、<0.05)呈正相关,PDR组hsCRP与TG、FINS、HI(r值分别为0.552、0.452、0.382,P值分别为<0.01、<0.01、<0.05)呈正相关,与ISI呈负相关(r=-0.512,P<0.01);PDR组Hcy与TG、TC、FBG、BMI(r值分别为0.752、0.652、0.512、0.432,均为P<0.01)呈正相关,与ISI呈负相关(r=-0.312,P<0.01);PDR组Hcy水平与hsCRP呈正相关(r=0.344,P<0.05)。结论 2型糖尿病伴DR者Hcy和hsCRP水平升高,PDR患者Hcy和hsCRP较BDR患者升高。Hcy和hsCRP可能是DR的危险因素,高Hcy可能使CRP水平升高进而引起DR。

Objective To investigate correlation of homocysteine（Hcy）and high sensitive C-reactive protein（hsCRP）with diabetic retinopathy（DR）in type 2 diabetic mellitus patients.Methods A total of 212 patients with type 2 diabetic mellitus were divided into 3 groups,non-diabetic retinopathy（NDR）group（102 cases）,background diabetic retinopathy（BDR）group（66 cases）and proliferative diabetic retinopathy（PCR）group（44 cases）.Levels of Hcy and hsCPR were determined.Parameters like blood fat,fasting insulin（FINS）,insulin sensitive index（ISI）,hospital interval（HI）,body mass index（BMI）,total cholesterin（TC）,triglyeride（TG）and fasting blood glucose（FBG）were detected and compared among 3 groups.The correlations of Hcy and hsCRP with DR were determined.Results Levels of hsCRP and Hcy in BDR group and PDR group were obviously higher than those in NDR group（all P0.01）.Levels of hsCRP and Hcy in PDR group were higher than those in BDR group（both P0.05）.DR had positive correlation with hsCRP,Hcy,HI and TC（r=0.615,P0.01;r=0.556,P0.01;r=0.356,P0.05;r=0.252,P0.05）.In PDR group,hsCRP had positive correlation with TG,FINs and HI（r=0.552,P0.01;r=0.452,P0.01;r=0.382,P0.05）,but with negative correlation with ISI（r=-0.512,P0.01）;Hcy had positive correlation with TG,TC,FBG and BMI（r=0.752,0.652,0.512,0.432;all P0.01）,but with negative correlation with ISI（r=-0.312,P0.01）;Hcy had positive correlation with hsCRP（r=0.344,P0.05）.Conclusions Levels of Hcy and hsCRP increase in DR patients with type 2 diabetes mellitus.Levels of Hcy and hsCRP in PDR patients are higher than those in BDR patients,which may be the risk factors of DR.High Hcy can promote CRP level and induce DR.