血清同型半胱氨酸水平与2型糖尿病肾病的相关性研究

目的 探讨血清同型半胱氨酸水平与2型糖尿病和糖尿病肾病的相关性。方法 选取广西医科大学第一附属医院于2017年9月至2018年3月收治的2型糖尿病患者及同期参加体检的健康对照者作为研究对象,病例组63例,其中糖尿病肾病组33例,单纯糖尿病组30例;对照组64例。比较各组受检者的同型半胱氨酸水平和高同型半胱氨酸发生率,分析同型半胱氨酸水平与其他指标的相关性。结果 糖尿病肾病组患者的同型半胱氨酸水平为(16.52±4.78)μmol/L,高于单纯糖尿病组的(16.52±4.78)μmol/L,差异有统计学意义(P<0.05);经Pearman相关性分析结果显示,病例组的24 h尿微量白蛋白水平与收缩压、舒张压、肌酐、尿素氮、同型半胱氨酸等指标呈正相关(r=0.359、0.268、0.726、0.389、0.546,P<0.05);病例组的高半胱氨酸患病率84.62%高于对照组15.38%;糖尿病肾病组患者的高同型半胱氨酸患病率为66.67%,明显高于单纯糖尿病组的33.33%,差异有统计学意义(P<0.05)。结论 血清同型半胱氨酸水平与糖尿病肾病损伤程度密切相关,监测血清同型半胱氨酸对糖尿病肾病的早期诊断,早期治疗有重要意义。

Correlation between serum homocysteine level and type 2 diabetic nephropathy

Objective To investigate the correlation between serum homocysteine level and type 2 diabetic nephropathy. Methods The type 2 diabetes mellitus (T2DM) patients accommodated in The First Affiliated Hospital of Guangxi Medical University from September 2017 to March 2018 and the healthy controls who took part in physical examinations at the same time were selected as study objects. There were 33 cases in a type 2 diabetic nephropathy group, 30 cases in a simple T2DM group, and 64 cases in a control group. The homocysteine levels and the incidence of hyperhomocysteine were compared among the three groups, and the correlation between the homocysteine level and other indexes was analyzed respectively. Results The average level of homocysteine in the type 2 diabetic nephropathy group was (16.52±4.78) μmol/L, which was significantly higher than that in the simple T2DM group (P<0.05). In the T2DM patients, there was a positive correlation between 24h urinary albumin and systolic blood pressure, diastolic blood pressure, creatinine, urea nitrogen, and homocysteine (r=0.359, 0.268, 0.726, 0.389, 0.546 respectively, all P<0.05). The prevalence of hyperhomocysteine in the T2DM patients was 84.62%, which was significantly higher than that in the persons of the control group (15.38%) (P<0.05). The prevalence of hyperhomocysteine in the type 2 diabetic nephropathy group was 66.67%, which was significantly higher than that (33.33%) in the simple T2DM group (P<0.05). Conclusion The level of serum homocysteine is closely related to the degree of type 2 diabetic nephropathy injury. It is important to monitor serum homocysteine level for early diagnosis and early treatment of diabetic nephropathy.