血浆同型半胱氨酸和炎性反应与糖尿病周围神经病变的关系

目的探讨血浆同型半胱氨酸(Hcy)和炎性反应对糖尿病周围神经病变(DPN)的影响及潜在机制。方法将126例糖尿病患者按神经自觉症状和肌电图检查分为单纯糖尿病组(SDM组,70例)和DPN组56例,所有患者测血浆Hcy浓度、血糖、糖化血红蛋白、血脂、肌酐及血清高敏C反应蛋白(hs-CRP)、TNF-α水平,分析Hcy与各指标的相关性。结果 DPN组患者年龄、糖尿病痛程、糖化血红蛋白、血浆Hc y、hs-CRP和TNF-α水平均显著高于SDM组(P<0.05)。年龄、糖尿病病程、血浆Hcy、hs-CRP、TNF-α水平与DPN相关,在控制年龄、糖尿病痛程等因素后,Hcy仍然为DPN的独立危险因素。结论高Hcy血症是DPN的独立危险因素,其机制可能与其促进炎性反应,损伤血管内皮功能,加重神经损伤有关。

Relation of homocysteine and inflammatory reaction with diabetic perineuropathy

Objective To study the effect of homocysteine and inflammatory reaction on diabetic perineuropathy(DPN).Methods One hundred and twenty-six diabetes mellitus(DM) patients were divided into simple DM(SDM) group and DPN group according to their subjective symptoms and electromyography.Plasma levels of homocysteine,glucose,glycosylated hemoglobin,lipid,creatinine, high sensitivity C-reactive protein(hs-CRP) and tumor TNF-αwere measured in the patients and relation of homocysteine with the above parameters was analyzed.Results The age was older,the course of DM was longer,and the palsma levels of glycosylated hemoglobin,homocysteine, hs-CRP and TNF-αwere higher in DPN group than in SDM group(P<0.05).Single variate regression analysis showed that they were related with DPN.Multivariate regression analysis showed that homocysteine was an independent risk factor for DPN after the adjustment of age and course of DM.Conclusion Hyperhomocysteinemia,an independent risk factor for DPN,induces DPN by promoting inflammatory reaction,damaging vascular endothelial function,and detriorating nerve injury.