糖尿病患者血糖和血脂水平改善与血浆同型半胱氨酸水平的相关性

目的探讨2型糖尿病（T2DM）患者不同血糖状态及降血糖治疗对血浆同型半胱氨酸（Hcy）水平的影响。方法对225例无明确并发症和合并症的T2DM患者，分别测定FPG、2hPG、血脂、血浆Hcy。其中病程3个月内患者43例，进行药物等综合降血糖治疗3个月后再检测以上指标。统计分析血糖控制水平及随访前后糖脂指标变化和Hcy的关系。结果血糖控制良好的患者血浆Hcy水平较血糖控制差的显著降低（14．10±3．92vs15．44±4．28，P〈0．05）；新诊断的患者治疗后血浆Hey水平也较治疗前显著降低（14．18±4-2．26vs15．25±2．41，P〈0．01），血糖控制较好的患者血浆Hcy水平仍较正常人偏高。相关分析显示，血浆Hcy水平主要与FPG和HbA1c正相关（分别r=0．193，0．274，P〈O．01）。结论糖尿病患者的血浆Hcy水平升高，良好控制血糖，可以降低血浆Hcy浓度。

The relationship of plasma homocysteine concentration with improvement of blood glucose and lipid profiles in type 2 diabetes mellitus

Objective To study the effect of lowering blood glucose and lipids on plasma homocyteine concentration. Method 225 type 2 diabetic patients without definite diabetic complications received the assays of blood glucose, lipids and Hcy. They were divided into two groups： HbA1c〉7% and ≤ group. The 43 of 225 cases with diabetic course shorter than 3 months were re-evaluated by above parameters after 3 months of hypoglycemic treatment to observe the relationship of blood glucose and lipids control with plasma homocyteine concentration. Result Plasma homocyteine concentration was significant lower in HbA1c≤7% group than in HbA1c〉7% group （14.10±3.92 vs 15.44±4.28, P d0.05）. After 3 months hypoglycemic treatment the Hcy concentration was significantly decreased as compared with pretreatment （14.18±2.26 vs 15.25±2.41, P〈0.001）. Hcy was related to FPG and HbA1c. Conclusion The plasma homocyteine concentration is increased in diabetic patients versus healthy control. The plasma homocyteine is associated with blood glucose control.