血清叶酸和维生素B_(12)与早期糖尿病肾病的关系

Relationship between serum folic acid,vitamin B_(12) and early diabetic nephropathy

目的探讨血清叶酸和维生素B_(12)与早期糖尿病肾病(DN)的关系。方法选择2015年1~9月上海市普陀区人民医院收治的成人2型糖尿病(T2DM)患者120例,根据尿微量白蛋白排泄率(UAER)分为单纯糖尿病(SDM)组(UAER<30 mg·g^(-1))和早期DN(EDN)组(UAER 30~300 mg·g^(-1)),每组60例;另选取同期健康成人60例作为对照组。采用化学发光法测定血清叶酸和维生素B_(12)水平,乳胶增强免疫透射比浊法测定血清胱抑素C水平;对3组受试者血清叶酸、维生素B_(12)和胱抑素C水平进行比较。结果 SDM组和EDN组患者血清胱抑素C水平显著高于对照组(P<0.01);EDN组患者血清胱抑素C水平高于SDM组,但差异无统计学意义(P>0.05)。SDM组和EDN组患者血清叶酸水平显著低于对照组(P<0.05),EDN组患者血清叶酸水平显著低于SDM组(P<0.05)。3组受试者血清维生素B_(12)水平比较差异无统计学意义(P>0.05)。对照组、SDM组和EDN组受试者叶酸缺乏症患病率分别为0.0%(0/60)、38.3%(23/60)和48.3%(29/60),SDM组和EDN组患者叶酸缺乏症患病率显著高于对照组(P<0.01),EDN组与SDM组患者叶酸缺乏症患病率比较差异无统计学意义(P>0.05)。对照组、SDM组和EDN组受试者维生素B_(12)缺乏症患病率分别为0.0%(0/60)、6.7%(4/60)和8.3%(5/60),3组受试者维生素B_(12)缺乏症患病率比较差异无统计学意义(P>0.05)。结论 T2DM患者存在血清叶酸缺乏,叶酸可能与EDN有关,但未发现维生素B_(12)与EDN有相关性。

Objective To investigate the relationship between serum folic acid,vitamin B12 and early diabetic nephropathy（ DN）. Methods A total of 120 adult patients with type 2 diabetes mellitus（ T2DM） were selected in People＇s Hospital of Putuo District of Shanghai City from January 2015 to September 2015. The patients were divided into simple diabetes mellitus（ SDM） group（ urinary albumin excretion rate,UAER 〈30 mg ·g^-1 and early DN（ EDN） group（ UAER 30 -300 mg·g^-1 according to UAER,60 patients in each group. Sixty healthy adults were selected as control group at the same time. The levels of serum folic acid and vitamin B12 were detected by chemiluminescence method,and the level of serum cystatin C was detected by latex enhanced immune transmission turbidity method. The levels of serum folic acid,vitamin B12 and cystatin C were compared in the three groups. Results The level of serum cystatin C in SDM group and EDN group was significantly higher than that in control group（ P〈0. 01）. The level of serum cystatin C in EDN group was higher than that in SDM group,but the difference was not statistically significant（ P〈0. 05）. The level of serum folic acid in SDM group and EDN group was significantly lower than that in control group（ P〈0. 05）,and the level of serum folic acid in EDN group was significantly lower than that in SDM group（ P〈0. 05）. There was no significant difference in serum vitamin B12 level among the three groups（ P〉0. 05）. The incidence of folic acid deficiency in control group,SDM group and EDN group was 0. 0%（ 0/60）,38. 3%（ 23/60） and 48. 3%（ 29/60）,respectively; the incidence of folic acid deficiency in SDM group and EDN group was significantly higher than that in control group（ P〈0. 01）; but there was no significant difference in the incidence of folic acid deficiency between EDN group and SDM group（ P〉0. 05）. The incidence of vitamin B12 deficiency in control group,SDM group and EDN group was 0. 0%（ 0/60）,6. 7%（ 4/60） and 8. 3%（ 5/60）,respectively; there was no significant difference in the incidence of vitamin B12 deficiency among the three groups（ P〉0. 05）. Conclusion Serum folic acid and vitamin B12 deficiency existed in patients with T2 DM. Serum folic acid metabolism may be correlated to EDN. But the correlation between vitamin B12 and EDN is not found.