老年新诊2型糖尿病患者血浆同型半胱氨酸与颈动脉硬化的关系

目的探讨老年新诊2型糖尿病患者血浆同型半胱氨酸(Hcy)与颈动脉硬化的关系。方法测定92例老年新诊2型糖尿病患者和48例健康对照者(对照组)的血浆Hcy、血清白细胞介素-8(IL-8)、叶酸、维生素B12、颈动脉内膜中层厚度(IMT)。将糖尿病患者分为IMT正常组(24例)I、MT增厚组(24例)、斑块组(44例);再将斑块组分为稳定斑块亚组(32例)、不稳定斑块亚组(12例),并进行分析。结果新诊2型糖尿病患者血浆Hcy水平明显高于对照组(P<0.05),且在IMT正常组、IMT增厚组、斑块组逐步升高(P<0.05),并且不稳定斑块亚组高于稳定斑块亚组(P<0.05)。血浆Hcy水平与IL-8呈正相关,与叶酸、维生素B12呈负相关。结论Hcy是老年新诊2型糖尿病患者颈动脉硬化的重要危险因素之一,并可能通过IL-8参与动脉硬化的发展;血浆Hcy水平与颈动脉硬化的程度及斑块的稳定性有关。

The relationship between plasma homocysteine and carotid atherosclerosis in elderly patients with newly diagnosed type 2 diabetes mellitus

Objective To investigate the relationship between plasma homocysteine(Hcy) and carotid atherosclerosis in elderly patients with newly diagnosed type 2 diabetes mellitus(T2DM).Methods The plasma level of Hcy,the serum level of interleukin-8(IL-8),VitB12,folic acid and the carotid intima-media thickness(IMT) were measured in 92 elderly patients with newly diagnosed T2DM and 48 normal elderly.Based on IMT,the DM patients were divided into three groups:IMT normal group,IMT thickened group and plaque group.Results Compared with normal elderly,the DM patients generally had higher plasma levels of Hcy.Among T2DM patients,the plasma levels of Hcy in IMT thickened group were higher than those in IMT normal group(P<0.05);those in plaque group were also higher than those in IMT thickened group(P<0.05).Among plaque groups,the plasma levels of Hcy in patients with unstable plaques were higher than those in patients with stable plaques(P<0.05).The plasma level of Hcy was positively correlated with IL-8 and negatively correlated with VitB12 and folic acid.Conclusions Hcy is one of the important risk factors for the carotid atherosclerosis in elderly patients with newly diagnosed T2DM and possibly takes part in the development of atherosclerosis through IL-8.The plasma levels of Hcy are related with the extent of atherosclerosis and plaque stability.