血清同型半胱氨酸与胱抑素C和老年2型糖尿病大血管病变的关系

目的研究血清同型半胱氨酸(Hcy)和胱抑素C(Cysc)水平与老年2型糖尿病(T2DM)大血管病并发症的关系和临床意义。方法选取105例老年T2DM患者分为两组:大血管病组51例,无大血管病组54例,以32例健康体检者为对照组。检测血清Hcy、Cysc,收集研究对象一般资料及生化检查结果。结果①糖尿病大血管病变组血清Hcy、Cysc水平显著高于无大血管病变组,差异有统计学意义(P<0.05);糖尿病无大血管病变组Hcy、Cysc水平高于健康对照组(P<0.05)。②以糖尿病大血管病变为因变量,多因素Logis-tic逐步回归分析示Hcy、Cysc能进人回归模型,其优势比(OR)分别为6.404,3.943,其95%CI分别为(1.706,18.486),(1.151,13.504)。结论血清Hcy及Cysc升高可作为提示老年T2DM患者糖尿病大血管病变危险性增加的参考指标;并可能是老年T2DM患者大血管病变的独立危险因素之一。

Relationship between levels of homocysteine and cystatin c in serum and vascular complications in elderly type 2 diabetics

Objective To study clinical significance and relationship among levels of Hcy and Cysc in serum and macro-vascular complications(MVC)in elderly T2DM.Methods 105 elder patients with T2DM were divided into 2 groups,54 cases without MVC(NMVC group);51 with MVC(MVC group),32 healthy volunteers were chosen as the healthy control group.Levels of Hcy and Cysc were respectively determined by HPLC and PETIA in all the subjects when general condition and biochemical indicators of objects were collected.Results ① The levels of Hcy and Cysc in MVC group were significantly higher than those in NMVC group(P<0.05).The levels of Hcy and Cysc in NMVC group were higher than those in healthy control group(P<0.05).② Multiple stepwise regression analysis result showed that the levels of Hcy and Cysc may be the effective factors of vascular lesion in T2DM.It showed dominance ratio of Hcy(6.404),95%CI(1.706,18.486) and Cysc(0.25),95%CI(1.151,13.504).Conclusion Increased serum Hcy and Cysc level can be used as a valuable reference markers in the indicating and monitoring of vascular complications in elderly T2DM.