高同型半胱氨酸血症与老年糖尿病肾病及胰岛素抵抗相关性研究

Study on the Correlation Between Hyperhomocysteinemia and Senile Diabetic Nephropathy and Insulin Resistance

目的探讨高同型半胱氨酸血症与老年糖尿病肾病以及胰岛素抵抗性的相关性。方法选择该院收治的80例老年糖尿病肾病患者(观察组)与80例健康人员(对照组),进行血清tHcy水平对比,并在观察组内按照肾病严重情况再次分成3组,对比分析每组的血清tHcy水平,使用单因素分析法对血清tHcy于患者年龄、胰岛素相关指标、尿白蛋白排泄率(UAER)等相关指标进行相关性分析。结果观察组血清tHcy水平显著高于对照组,差异有统计学意义(P<0.05),且血清tHcy水平随着患者的肾病程度不断严重而逐渐升高,单因素相关性分析后显示,血清tHcy水平与患者年龄、肌酐水平、尿酸水平、尿白蛋白排泄率、胰岛素抵抗性等均具有正相关关系,与内生肌酐清除率呈负相关。结论高同型半胱氨酸血症与老年糖尿病肾病患者的肾功能受损以及胰岛素抵抗性情况有十分重要的关系。

Objective To investigate the correlation between hyperhomocysteinemia and senile diabetic nephropathy and insulin resistance. Methods 80 cases of elderly patients with diabetic nephropathy （observation group） and 80 healthy persons （control group） admitted in our hospital were selected. The serum level of tHcy of two groups was compared, and in accordance with nephropathy serious situation, the observation group patients were again divided into three groups, the serum tHcy levels of the groups were analyzed and compared. The correlation between serum tHcy, age, related indexes of insulin and urinary albumin excretion rate（ UAER ） was analyzed by single factor analysis method. Results The serum level of tHcy of the observation group was significantly higher than that of the control group, the difference was significant （P〈0.05）, and the serum tHcy level of patients with nephropathy increased gradually along with the advance of nephropathy. Correlation analysis of single factor showed that, the level of tHcy in serum had positive correlation with the age of patients, serum creatinine, uric acid, UAER, insulin resistance, and had negative correlation with endogenous creatinine clearance rate. Conclusion Hyperhomocysteinemia has very important relationship with diabetic nephropathy in the elderly patients with impaired renal function and insulin resistance.