胰岛素抗体阳性的2型糖尿病患者血清同型半胱氨酸水平变化的研究

目的探讨胰岛素抗体(INS-Ab)阳性T2DM患者血清同型半胱氨酸(Hcy)水平的变化。方法选取305例行重组人胰岛素治疗的T2DM患者,其中INS-Ab阳性患者(INS-Ab阳性组)82例,INS-Ab阴性患者(INS-Ab阴性组)223例,另选取同期我院健康体检人群200名为正常对照(NC)组。研究对象进行体格检查和血脂、血糖、胰岛素、血清Hcy、INS-Ab等相关指标的测定。结果INS-Ab阳性组血清Hcy水平高于INS-Ab阴性组和NC组(15.94±3.28)vs(12.68±3.58)vs(7.89±2.16)μmol/L,P<0.01]。Pearson相关分析显示,INS-Ab阳性组血清Hcy水平与BMI、LDL-C、TC、TG、FPG、FIns、HbA1c呈正相关(r=0.158、0.197、0.191、0.176、0.204、0.211、0.208,P=0.021、0.011、0.018、0.025、0.005、0.001、0.002),与年龄、SBP、DBP、胰岛素用量和HDL-C不相关;INS-Ab阴性组与上述相似。Logistic回归分析显示,血清Hcy水平是T2DM患者INS-Ab阳性的影响因素(P=0.008);按照血清Hcy水平三分位数将T2DM患者分为3组,随着Hcy升高,INS-Ab阳性率逐渐升高(9.81%vs 23.52%vs 46.15%,P<0.05)。结论INS-Ab阳性T2DM患者血清Hcy升高,血清Hcy水平是INS-Ab阳性的影响因素。

Relationship between positive insulin antibody and serum homocysteine levels in patients with type 2 diabetes

Objective To explore the changes of serum homocysteine(Hcy)level in type 2 diabetes mellitus patients(T2 DM)with positive INS-Ab.Methods 305 T2 DM patients treated with recombinant human insulin were selected,including 82 with positive INS-Ab(INS-Ab positive group)and 223 with negative INS-Ab(INS-Ab negative group).200 healthy subjects were randomly selected as normal controls(NC).Clinical data,lipids,blood glucose,insulin,Hcy and INS-Ab were measured.Results Serum Hcy level in INS-Ab positive group was higher than that in INS-Ab negative group and NC group(15.94±3.28)vs(12.68±3.58)vs(7.89±2.16)μmol/L,P<0.01].Pearson correlation analysis showed that serum Hcy levels in INS-Ab positive group were positively correlated with BMI,LDL-C,TC,TG,FPG,FIns and Hb A1 c(r=0.158,0.197,0.191,0.176,0.204,0.211 and 0.208,P=0.021,0.011,0.018,0.025,0.005,0.001 and 0.002),but not with age,SBP,DBP,insulin dosage and HDL-C.The results of correlation analysis in INS-Ab negative group were similar.Logistic regression analysis showed that Hcy level was an independent risk factor of positive INS-Ab in T2 DM(P=0.008).According to the tertiles of serum Hcy level,the positive rate of INS-Ab increased gradually with the increase of Hcy in T2 DM patients(9.81%vs 23.52%vs 46.15%,P<0.05).Conclusion Elevated serum Hcy level is an influencing factor of INS-Ab positivity in T2 DM patients.