同型半胱氨酸与糖尿病合并缺血性脑血管病的相关性研究

Relationship of homocysteine with type 2 diabetes complicated with ischemic cerebrovascular diseases

目的研究同型半胱氨酸与糖尿病合并缺血性脑血管病的相关性。方法将2型糖尿病患者67例分为2组无缺血性脑血管病组,34例,平均年龄(62.2±6.7)岁;合并缺血性脑血管病组,33例,平均年龄(62.9±9.9)岁。选择同期健康体检者30例为对照组,平均年龄(62.6±7.3)岁。对生化指标进行测定,包括Hcy水平、TC、TG、HDLC、LDLC和FPG,比较各组间生化指标的差异、影响糖尿病合并缺血性脑血管病发生的因素及Hcy水平与各指标的相关性。结果糖尿病组患者与健康人群组比较,FPG、TG、TC、LDLC和Hcy水平较高,而HDLC较低,差异有统计学意义(P<0.05);在糖尿病患者中,合并缺血性脑血管病患者的Hcy水平高于未合并者;Hcy是影响糖尿病合并缺血性脑血管病发生的主要因素;Hcy与HDLC之间呈负相关性,与LDLC之间呈正相关性;在糖尿病合并脑血管病患者中,男性的Hcy水平明显高于女性的(P=0.009),老年人Hcy水平高于非老年人的(P=0.000)。结论 Hcy是2型糖尿病患者合并缺血性脑血管病发病的主要风险因素,因此监测Hcy水平对防治该疾病非常重要。

Objective To investigate the relationship of homocysteine with type 2 diabetes associated ischemic cerebrovascular diseases （ICVD）. Methods Sixty-seven patients with type 2 diabetes mellitus （T2DM） were selected and divided into two groups, patients without ICVD （ n=34, with mean age of 62.2±6.7 years） and patients with ICVD （ n=33, with mean age of 62.9± 9.9 years）. Thirty healthy people with mean age of 62.6±7.3 years were chosen as a control group. The biochemical parameters involving Homocysteine （Hcy）, Total Cholesterol （TC）,Triglyceride （TG）,High Density Lipoprotein Cholesterol （HDLC）,Low Density Lipoprotein Cholesterol （LDLC）, and Fasting Plasma Glucose （FPG） were tested using standard procedures and evaluated with statistical software. Moreover, factors affecting T2MD with ICVD were analyzed, as well as the association of Hcy with other biochemical parameters. Results Levels of FPG, TG, TC, LDLC and Hcy in patients with T2DM were higher than that of the healthy people. In patients with T2DM, the Hcy levels in patients with ICVD were higher than others. Still, Hcy was the main factor that might lead to the development of T2DM with ICVD. Furthermore, a positive association between Hcy and HDLC, as well as a negative relationship between Hcy and LDLC, were found. In addition, male patients with ICVD had higher Hcy levels than female patients. Similarly, the elderly patients with ICVD had higher Hcy levels than young patients. All differences were significant （p〈0.05）. Conclusion Hcy is an important risk factor for T2DM with ICVD. Therefore, monitoring the Hcy levels is important for preventing and treating of the disease.