2型糖尿病患者血糖控制与血清Hcy水平及其他影响因素的相关性研究

Effect of Glycemic Control on Serum Homocysteine Levels in Type 2 Diabetes Mllitus and Its Association with Other Factors

目的探讨2型糖尿病(T2DM)患者血糖控制与血清同型半胱氨酸(Hcy)水平及其他影响因素的相关性。方法选取2018年7~10月在上海市浦东新区公利医院内分泌门诊诊断为T2DM的成人患者370例为研究对象。检测患者糖化血红蛋白(HbA1c),Hcy,低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDL-C)等水平。根据HbA1c水平将370例T2DM患者分为HbA1c≤7%和HbA1c>7%两组,分析Hcy,LDL-C和HDL-C等水平差异。根据Hcy水平将370例T2DM患者分为高Hcy组(Hcy>15.4μmol/L)和正常Hcy组(Hcy≤15.4μmol/L),进行两组患者HbA1c,LDL-C和HDL-C等水平的单因素分析,采用Logistic回归分析评估高水平Hcy的危险因素。结果 HbA1c分组中,HbA1c较低组患者的Hcy,年龄和LDL-C均低于HbA1c较高组,差异均有统计学意义(t=-3.76,0.85,-2.02,均P<0.05)。Hcy分组中,高Hcy组患者的HbA1c,年龄均高于正常Hcy组,HDL-C低于正常Hcy组,男性患者多于女性患者,差异均有统计学意义(χ^2=15.39,5.78,7.46,11.95,均P<0.05)。Logistic回归分析显示,性别、HbA1c,年龄和HDL-C这四个因素是影响T2DM患者Hcy水平升高的危险因素(P<0.05)。结论控制血糖能够影响2型糖尿病患者血清Hcy水平,起到预防心血管疾病的重要作用。

Objective To investigate the effect of glucose control on serum homocysteine(Hcy) levels in type 2 diabetes mellitus(T2DM) and its association with other factors.Methods A retrospective study was performed on 370 adult patients diagnosed with type 2 diabetes mellitus(T2DM) in the endocrine clinic of Gongli Hospital to Pudong New Area in Shanghai from July 2018 to October 2018.The hemoglobin A1c(HbA1c),Hcy low density lipoprotein cholesterol(LDL-C) and high density lipoprotein cholesterol(HDL-C) levels of in patients were tested.According to the level of HbA1c,370 patients with type II diabetes were divided into two groups:HbA1c ≤7% and HbA1c >7%.The differences in Hcy,LDL-C and HDL-C levels were analyzed.According to the level of Hcy,370 patients with T2DM were divided into two groups:high Hcy(Hcy>15.4 μmol/L) and normal Hcy(Hcy≤15.4 μmol/L.Univariate analysis of HbA1c,LDL-C and HDL-C levels in these two groups was carried out,and Logistic multivariate regression analysis was used to determine the risk factors of high Hcy level.Results In HbA1c group,the Hcy,age and LDL-C with lower HbA1c were lower than those with higher HbA1c,and the difference was statistically significant(t=-3.76,0.85,-2.02,all P<0.05),respectively.In the Hcy group,the age and HbA1c with high Hcy group was higher than that in the normal Hcy group,and the HDL-C was lower than that in the normal Hcy group,the male patients were more than the female patients,and the difference was statistically significant(χ^2=15.39,5.78,7.46,11.95,all P<0.05),respectively.Multivariate regression analysis showed that age,sex and HbA1c and HDL-C were the risk factors for the increase of Hcy level in T2DM patients(P<0. 05).Conclusion Good glycem control can affect the level of serum Hcy and play an important role in preventing cardiovascular diseases in T2DM patients.