血清同型半胱氨酸和C反应蛋白与2型糖尿病周围血管病变的关系

目的观察血清同型半胱氨酸（Hcy）和C反应蛋白（CRP）与2型糖尿病周围血管病变（PVD）的关系。方法将58例2型糖尿病患者按是否伴有PVD分为单纯2型糖尿病组（DM组，30例）和PVD组（28例），另选健康体检者25例作为对照组，检测三组空腹血糖（FBG）、糖化血红蛋白（HbA，e）、总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、Hcy、CRP，并计算体质指数（BMI）及踝肱比等。结果三组BMI、TG、TC、HDL—C比较差异无统计学意义（P〉0．05）。DM组、PVD组FBG、HbA1c、LDL．C明显高于对照组[（7．54±1．25）、（8．12±1．57）mmol／L比（4．68±0．54）mmol／L，（6．92±0．89）％、（7．544-O．97）％比（4．80±0．54）％，（3．79±0．73）、（4．41±0．93）mmol／L比（2．68±0．54）mmol／L]，差异有统计学意义（P〈0．05）；但PVD组和DM组比较差异无统计学意义（P〉0．05）。DM组、PVD组Hcy、CRP明显高于对照组[（10．26±3．62）、（19．83±5．54）μmol／L比（8．92±2．41）μmol／L，（4．12±0．57）、（5．47±0．85）mg／L比（2．73±0．54）mg／L]，踝肱比明显低于对照组（0．92士0．18、0．81±0．16比1．02±0．23），差异有统计学意义（P〈0．05）；而且PVD组Hey、CRP明显高于DM组，踝肱比明显低于DM组，差异有统计学意义（P〈0．05）。Spearman分析结果显示，Hey与踝肱比呈负相关（r=-0．635，P〈0．05），CRP与踝肱比呈负相关（r=-0．529，P〈0．05），Hey与CRP呈正相关（r=0．528，P〈0．05）。偏相关分析结果显示，Hey与踝肱比仍呈负相关（r=-0．315，P〈0．05），CRP与踝肱比仍呈负相关（r=-0．243，P〈0．05）。结论ttcy和CRP参与了2型糖尿病PVD的发生和发展，可以作为2型糖尿病PVD的预测因子。

Relationship between homocysteine,C-reactive protein and type 2 diabetes peripheral vascular disease

Objective To observe the relationship between homocysteine （Hcy）, C-reactive protein （CRP） and type 2 diabetes peripheral vascular disease （PVD）. Methods Fifty-eight patients with type 2 diabetes according to the condition of PVD were divided into simple type 2 diabetes mellitus group （DM group, 30 cases ） and PVD group （28 cases）. Twenty-five healthy people were chosen at the same period as control group. The fasting blood glucose （FBG）, glycosylated hemoglobin （HbA,c）, total cholesterol（TC）, triglyceride （TG）,high-density lipoprotein cholesterol （HDL-C） and low-density lipoprotein cholesterol （LDL-C）,Hcy and CRP levels were detected among 3 groups,and the body mass index （BMI）, ankle brachial index（ABI） was calculated. Results The BMI,TG,TC and HDL-C levels among 3 groups had no statistical significance （P 〉0.05）. The FBG,HbAjc and LDL-C in DM group and PVD group were significantly higher than those in control group [ （7.54 ± 1.25）, （8.12 ± 1.57） mmol/L vs. （4.68 ± 0.54） mmol/L; （6.92 ± 0.89）%, （ 7.54 ± 0.97 ）% vs. （4.80 ± 0.54 ） % ; （ 3.79 ± 0.73 ）, （4.41 ±0.93 ） mmol/L vs. （ 2.68 ± 0.54 ） mmol/L ], and the difference was statistically significant （P 〈 0.05 ）. But the difference betweenPVD group and DM group had no statistical significance （P 〉 0.05）. Hcy and CRP in DM group and PVD group were higher than those in control group [ （10.26 ± 3.62）, （19.83 ± 5.54） μ mol/L vs. （8.92 ± 2.41 ） mol/L; （4.12 ± 0.57 ）, （5.47 ± 0.85 ） mg/L vs. （2.73 ± 0.54） mg/L ], ABI was lower than that in control group （0.92 ± 0.18,0.81 ± 0.16 vs. 1.02 ± 0.23 ）, and the difference was statistically significant （P 〈 0.05 ） ; Hcy,CRP in PVD group were obviously higher than those in DM group, ABI was lower than that in DM group, and the differences were statistically significant （P 〈 0.05 ）. Spearman analysis showed that Hey was negatively correlated with ABI （r = -0.635, P 〈 0.05 ）, CRP was negatively correlated with ABI （r = -0.529, P 〈 0.05 ）, and Hey was positively correlated with CRP （r = 0.528 ,P 〈 0.05 ）. The partial correlation analysis results showed that Hey and ABI still showed a negative correlation （r = -0.315 ,P 〈 0.05）, CRP and ABI still showed a negative correlation （r = -0.243,P 〈 0.05 ）. Conehtsion Hcy and CRP participating in the occurrence and development of type 2 diabetes PVD, can be used as a predictor of type 2 diabetes PVD.