血浆同型半胱氨酸及高敏C反应蛋白水平与2型糖尿病周围神经病变的关系

目的:探讨同型半胱氨酸(Hcy)及高敏C反应蛋白(hs-CRP)与糖尿病周围神经病变(DPN)的关系。方法:将110例2型糖尿病患者分为糖尿病周围神经病变组(DPN组)62例和单纯糖尿病组(SDM组)48例,并设正常对照组(NC组)45例。所有受试者检测空腹血糖(FBG)、糖化血红蛋白(HbA1C)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、肌酐(Scr)、Hcy及hs-CRP水平。结果:与NC组比较,DPN组及SDM组Hcy及hs-CRP水平显著升高(P<0.01),且DPN组升高更明显(P<0.01)。多因素回归分析结果显示,HbA1C、病程、LDL-C、Hcy及hs-CRP与DPN的发生有关。结论:高Hcy血症及高hs-CRP水平是DPN的危险因素,可能与其促进炎症反应,损伤血管内皮,加重神经损伤有关。

Objective:To study the relation of homocysteine and high sensitivity C-reactive protein with Type 2 diabetic peripheral neuropathy(DPN). Methods:110 Type 2 diabetes mellitus(T2 DM) patients were divided into DPN and simple DM(SDM) group, and 45 cases were taken as control. All participants were evaluated for plasma levels of FBG, HbA1 C, TG, TC, HDL-C, LDL-C, Scr, Hcy and hs-CRP. Results:Compared with control group,the plasma levels of Hcy and hs-CRP in DPN group and SDM group were increased(P<0.01). The plasma levels of Hcy and hs-CRP in DPN group were significantly higher than those in the SDM group(P<0.01). Multivariate regression analysis showed that HbA1 C,the duration of diabetes, LDL-C, Hcy and hs-CRP were related with DPN. Conclusion:Hyperhomocysteinemia and high plasma level of hs-CRP were risk factors for DPN, induced DPN by promoting inflammatory reaction, damaging vascular endothelial function, and deteriorating nerve injury.