2型糖尿病肾病患者血清同型半胱氨酸、叶酸及维生素B12水平的相互关系

目的探讨2型糖尿病肾病患者空腹血浆同型半胱氨酸（Hcy）、叶酸（FA）及维生素B12（VitB12）水平的相互关系及其影响因素。方法165例2型糖尿病患者根据尿微量白蛋白排泄率（UAER）分为尿微量白蛋白正常糖尿病组（A组）、早期。肾病组（B组）、临床肾病组（C组），用酶联免疫吸附试验分别检测各组患者血浆Hey浓度，并同步应用发光免疫法测定血清FA、VitB12水平，与48例正常对照者（D组）进行比较。结果A组：UAERl（1．6±5．2）μg／min、HCY（14．8±3．6）μmol／L、FA（9．02±2．06）nmol／L、VitB12（552±162）pmol／L；B组UAER（82．9±45．8）μg／min、HCY（21．1±2．3）μmol／L、FA（7．85±2．45）nmol／L、VitB12（436±135）pmol／L；C组UAER（348．1±123．2）μg／min、HCY（32．3±2．5）μmol／L、FA（5．78±2．33）nmol／L、VitB12（292±92）pmol／L；D组UAER（10．9±5．3）μg／min、HCY（9．1±2．2）μmol／L、FA（10．39±2．93）nmol／L、VitB12（688±208）pmol／L。各组血Hey水平均明显高于正常对照组（P〈0．05），C组又高于A组和B组（P〈0．05），而FA、VitB12水平与对照组相比均显著降低（P〈0．05），C组又低于A组和B组（P〈0．05）。Hey与UAER呈正相关（P〈0．01），，与FA、VitB12呈负相关（P〈0。01）。结论定期测定糖尿病患者血浆Hcy、FA和VitB12有助于预测、判断2型糖尿病肾病的发展。

Detection and significance of homocysteic acid,folic acid and vitamin B_(12) levels in serum in the patients with type 2 diabetic nephropathy

Objective To investigate the relationship and the influencing factors of homocysteine(Hey),folic acid(FA)and vitamin B_(12)(VitB_(12))levels of fasting plasma in the patients with type 2 diabetic nephropathy.Method 165 cases with type 2 diabetes were divided into the normal urinary albumin in diabetic group(A group),early kidney disease group(B group),clinical nephropathy group(C group)according to urinary albumin excretion rate(UAER),patients in each group were detect the plasma Hcy concentration by enzyme-linked immunosorbent assay,and,in parallel,determinate the serum FA,VitB_(12) levels by immunoassay,compared with 48 cases of normal controis.Result Plasma Hcy in diabetic groups was significantly higher than the normal control group(P<0.05),C group was higher than A group and B group(P<0.05),and FA,VitB_(12) levels compared with the control group were significantly lower(P<0.05),C group was lower than A group and B group(P<0.05).Correlation.analysis indicated that the Hcy level of diabetic patients was positively correlated with UAER level(P<0.01),and negatively correlated with FA and VitB_(12) levels(P<0.01).Conclusion It is contribute for monitoring and determining the occurrence and development of the patients of type 2 diabetic nephropathy to determinate regularly the levels of plasma Hcy,FA,and VitB_(12) in patients with diabetes.