胰岛素治疗后血糖控制与2型糖尿病患者血浆同型半胱氨酸的关系

目的观察单纯胰岛素治疗的2型糖尿病患者,血糖控制水平与血浆总同型半胱氨酸（total homocysteine,tHcy）水平的关系。方法68例符合入选标准的2型糖尿病患者单纯给予胰岛素治疗3个月。基线和治疗3个月后取空腹血测定空腹血糖（FBG）、糖化血红蛋白（HbA1c）、tHcy,餐后2h取血测定餐后血糖（PBG）。结果所有患者经过3个月的单纯胰岛素治疗后,FBG、PBG和HbA1c均比治疗前显著下降（P〈0．01）。虽然治疗后血浆tHcy水平有下降趋势,但没有达到统计学显著水平（P〉0．05）。以HbA1c7．0％作为判断血糖控制水平的界值,治疗后HbA1c≤7．0％的患者31例（45．6％）,HbA1c〉7．0％的患者37例（54．4％）。治疗后HbA1c≤7．0％的患者,除FBG、PBG和HbA1c较治疗前显著下降外（P〈0．01）,tHcy也比治疗前显著降低（P〈0．01）。结论胰岛素强化治疗后,随着血糖控制改善,2型糖尿病患者血浆tHcy水平也明显下降。

The relationship between metabolic control and the plasma total homocysteine in type 2 diabetes treated with insulin

Objective To study the relationship between metabolic control and the plasma total homocysteine(tHcy) in type 2 diabetes treated with insulin.Methods A total of 68 patients with type 2 diabetes were recruited.At baseline and the end of 3 month therapy,fasting blood samples were collected for measuring fasting blood glucose(FBG),HbA1c,tHcy and other routine biochemical testing and postprandial blood was collected to measure postprandial blood glucose(PBG).Results FBG,PBG and HbA1c decreased significantly(P<0.01)after 3 month intensive insulin therapy.tHcy also decreased,but the decrease did not reach statistic significance(P>0.05).7.0% of HbA1c was selected as the cut point judging the level of metabolic control.The HbA1c level was less than 7.0% in 31(45.6%)patients after insulin treatment alone.In these patients,FBG,PBG and HbA1c significantly decreased,when compared with those of pre-treatment.The plasma tHcy decreased significantly as well.Conclusions After insulin treatment,the plasma tHcy decreases when the metabolic control is improved significantly.