2型糖尿病患者血清同型半胱氨酸与心室重构相关性研究

目的评价血清同型半胱氨酸(Hcy)与2型糖尿病(T2DM)患者心室重构的相关性。方法选取T2DM患者102例(T2DM组)及体检健康者90例(对照组),检测并比较两组血清Hcy水平。根据血清Hcy水平将T2DM组患者分为高Hcy组(Hcy≥15μmol/L)及正常Hcy组(Hcy<15μmol/L)。T2DM患者均检测血糖、血脂等生化指标,并采用美国超声心动图协会(ASE)推荐的标准方法测量舒张期末左室内径(LVD)、舒张期末左室后壁厚度(LVPW)、舒张期末室间隔厚度(IVS)以评估左室结构,计算左室质量(LVM)、左室质量指数(LVMI)。结果T2DM组患者血清Hcy水平显著高于对照组,差异有统计学意义(P<0.05)。高Hcy组患者LVD、IVS、RWT与正常Hcy组比较,差异无统计学意义(P>0.05);但两组的LVPW、LVM、LVMI比较,差异有统计学意义(P<0.05)。Hcy与LVMI(r=0.380,P=0.000)、LVPW(r=0.448,P=0.000)呈正相关。结论 T2DM患者存在Hcy代谢异常,高Hcy者LVPW、LVM、LVMI增高,血清Hcy增高对心室重构有影响。

Relationship between Homocysteic Acid and Ventricle Remodeling in Patients with Diabetes Mellitus

Objective To assess the relationship between homocysteic acid and ventricle remodeling in patients with diabetes mellitus.Methods 102 patients with T2DM(T2DM group) and 90 healthy controls(control group) were involved into the study.The levels of Hcy were detected in the two groups.Patients with T2DM were divided into high homocysteic acid group(HH) and normal homocysteic acid group(NH).Blood glucose and blood fat of the patients with T2DM were detected.Left ventricle inner diameter(LVD),left ventricular posterior wall thickness(LVPW) and interventricular septum thickness(IVS) were detected by standard method recommended by ASE to calculate left ventricular mass(LVM) and left ventricular mass index(LVMI).Results There was significant difference in the level of homocysteic acid between T2DM group and control group(P<0.05).There were no significant differences in the levels of LVD,IVS and RWT between HH group and NH group(P>0.05).There were significant differences in the levels of LVPW,LVM and LVMI between HH group and NH group(P<0.05).Hcy showed positive correlation with LVMI(r=0.380,P=0.000)and LVPW(r=0.448,P=0.000).Conclusion Patients with T2DM have metabolic disorder of homocysteic acid.Higher level of homocysteic acid can increase the levels of LVPW,LVM and LVMI.It indicates that high homocysteic acid played an important role in LV remodeling.