2型糖尿病合并高同型半胱氨酸血症对微血管病变患病率的影响

Influence of type 2 diabetes mellitus combined with high homocysteine on the morbidity rate of microangiopathy

目的探讨2型糖尿病(T2DM)合并高同型半胱氨酸血症(Hcy)对微血管病变患病率的影响。方法将278例T2DM患者按Hcy水平分为高Hcy组和正常Hcy组,对比两组的临床和生化指标以及糖尿病肾病(DN)、糖尿病视网膜病变(DR)、糖尿病周围神经病变(DPN)和糖尿病自主神经病变(DAN)的患病率。结果高Hcy组的T2DM病程、BMI、FBG、HbA1C、FINS、HOMA-IR、血Cr、CHOL、HDL水平等显著高于正常Hcy组(P<0.01);T2DM合并高Hcy组的微血管病变患病率较正常Hcy组高,以DN、DR患病率升高明显。结论 T2DM患者Hcy水平升高,与T2DM的代谢紊乱有关,与糖尿病微血管病变发生发展有关。

Objective To investigate the influence of type 2 diabetes mellitus（T2DM） combined high homocys- teine（Hcy） on the morbidity rate of microangiopathy. Methods 278 cases of T2DM patients were divided into the high Hcy group and the normal Hcy group according to their Hcy levels. The clinical and biochemical indicators as well as the morbidity rates of diabetic nephropathy （DN）, diabetic retinopathy （ DR）, diabetic peripheral neuropathy （DPN） ,and diabetic autonomic neuropathy（DAN） of the 2 groups were compared. Results The high Hcy group had significantly longer course of disease, higher levels of T2DM, BMI, FBG, HbA1C, FINS, HOMA-IR, bloodCr, CHOI., and HDI. than the normal Hcy group（ P 〈0.01）. The morbidity rate of microangiopathy in the group with T2DM combined with high Hcy was higher than that in the normal Hcy group,among which the morbidity rate of DN and DR rised especially obviously. Conclusion The rise of the Hcy of T2DM patients is related to metabolic disturbance of T2DM and the occurrence and development of microangiopathy.