T2DM患者血清25-(OH)D与HCY、β_2微球蛋白关系及临床意义

Relationship between serum 25-hydroxy vitamin D with HCY and β_2-microglobulin in patients with T2DM and its clinical significance

目的本研究通过检测2型糖尿病(T2DM)患者血清25-羟维生素D[25-(OH)D]和同型半胱氨酸(HCY)、β_2微球蛋白(β_2-MG)水平,探讨T2DM患者血清25-(OH)D和HCY、β_2-MG关系及临床意义。方法选择139例T2DM患者,根据尿清蛋白/肌酐(Alb/Cr)比值(UACR)分为正常Alb尿组(UACR<30mg/gCr)45例,微量Alb尿组(UACR≥30且<300mg/gCr)48例,大量Alb尿组(UACR≥300mg/gCr)46例,选取45例体检健康者作为对照组。采用电化学发光法检测血清25-(OH)D水平,酶法测定血清HCY水平,胶乳增强免疫比浊法测定血清β_2-MG水平,同时检测血糖(GLU)、糖化血红蛋白(HbA1C)、血肌酐(Cr)、血清钙(Ca2+)、磷(P5+)等生化指标。结果 DM患者血清25-(OH)D随着尿清蛋白的增加而降低,微量Alb尿组和大量Alb尿组血清25-(OH)D与正常Alb尿组和健康对照组比较明显降低,差异有统计学意义(P<0.01)。微量Alb尿组和大量Alb尿组血清HCY、β_2-MG水平较健康对照组均明显升高,差异有统计学意义(P<0.05)。结论血清25-(OH)D水平随着尿蛋白的增加而降低,血清HCY、β_2-MG水平随着尿蛋白的增加而增加,血清25-(OH)D水平与HCY、β_2-MG呈负相关。

Objective To detect the serum levels of 25-hydroxy vitamin D[25-（OH）D],homocysteine（HCY）and β_2-microglobulin（ β_2-MG）in the patients with type 2diabetes mellitus（T2DM）and to investigate the relationship between serum HCY and β_2-MG with 25-（OH）D and its clinical significance.Methods A total of 139 cases of T2 DM were selected anddivided into 3groups,the normal albuminuria group for[urinary albumin to creatinine ratio（UACR）30 mg/gCr,45cases],microalbuminuria group（UACR ≥30mg/gCr and300mg/gCr,48cases）and massive proteinuria group（UACR ≥300mg/gCr,46cases）according to the urinary albumin to creatinine ratio（UACR）.Other 45 individuals undergoing the physical examination were selected as the control group.The serum 25-（OH）D level was measured by electrochemiluminescence.Serum HCY level was determined by the enzymatic method.Serum β_2-MG level was measured by the latex enhanced immune turbidity method.At the same time,the biochemical indicators of FBG,HbA1 C,serum calcium and phosphorus were measured.Results The serum 25-（OH）D level was decreased with the increase of urinary albumin in the DM patients.And the serum 25-（OH）D level in the microalbuminuria group and the massive proteinuria group was significantly decreased compared with the normal albuminuria group and the control group,the difference was statistically significant（P〈0.01）.The serum HCY and β_2-MG levels in the microalbuminuria group and the massive proteinuria group were significantly increased compared with the healthy control group,the difference was statistically significant（P〈0.05）.Conclusion The serum 25-（OH）D level is decreased with the increase of urinary albumin in the diabetic patients.The serum HCY and β_2-MG levels are increased with the increase of urinary albumin and serum 25-（OH）D level is negatively correlated with the HCY and β_2-MG levels.