血浆同型半胱氨酸水平与2型糖尿病合并早期动脉粥样硬化的关系及干预效应分析

目的探讨血浆同型半胱氨酸（Hcy）水平与2型糖尿病（T2DM）合并早期动脉粥样硬化（AS）的关系及干预效应。方法158例T2DH患者（病程〈1年），无临床心、脑、肾及周围血管显性AS病史，依据颈动脉内膜-中层厚度（IMT）分为合并AS组（78例）和非AS组（80例），同时干预治疗随访1年；正常对照组30例。分别采血测定血浆Hey、血脂、血糖、糖化血红蛋白等指标。结果治疗前合并AS组和非AS组血浆Hey水平均明显高于正常对照组（P〈0．01），合并AS组血浆Hey水平显著高于非AS组（P〈0．0S）。干预治疗后非AS组及合并AS组血浆Hey水平虽仍高于正常对照组（P〈0.05或〈0．01）。但已较干预前明显下降（P〈0．01或〈0．05）。同时合并AS组颈动脉IMT也较干预前变薄（P〈0.05）。结论高Hey血症是T2DM合并早期AS的危险因素；强化血糖、血脂、血压控制治疗后血浆Hey水平明显下降，对T2DM合并AS有益。

Analysis of relationship between plasma homocysteine level and type 2 diabetes mellitus with atherosclerosis and effects after intervention

Objective To investigate the relationship between plasma homocysteine(Hcy) level and type 2 diabetes mellitus(T2DM)with atherosclerosis(AS), and the change after intervene-treatment. Methods According to carotid intima-media thickness(IMT) measured by color Doppler ultrasonography, 158 T2DM patients were divided into two groups: AS group(n=78)and non-AS group(n=80), who were received intensive treatment during the 1-year follow-up. Thirty normal subjects were as control group(NC group). The plasma Hcy concentration, plasma lipoprotein, fasting plasma glucose and HbA1c were analyzed in all subjects. Results The plasma Hcy levels in AS group and non- AS group were higher than those in NC group(P<0.01).The plasma Hcy levels in AS group was higher than those in non-AS group(P<0.05).The plasma Hcy levels in AS and non-AS group were decreased after intensive treatment(P<0.01 or <0.05), but still higher than that in NC group(P<0.05 or <0.01). At the same time, carotid IMT in AS group was thinner than that before intensive treatment. Conclusions There is correlation between high Hcy level,T2DM, and T2DM with AS. The plasma Hcy level in T2DM is decreased after intensive treatment, which is helpful to T2DM with AS.