老年2型糖尿病血清总同型半胱氨酸与糖尿病视网膜病变的关系

目的:探讨血清总同型半胱氨酸(HCY)水平与老年人2型糖尿病(DM)视网膜病变(DR)的关系。方法:70例2型糖尿病患者,对照组42例,分别测定血压(Bp)、体重指数(BMI),同型半胱氨酸(HCY)、空腹血糖(FPG)、空腹胰岛素(FNS)、糖化血红蛋白(GHb)、总胆固醇(CHO)、三酰甘油(TG)、血肌酐(Cr)、尿素氮(BUN)、尿酸(UA)、微量蛋白尿(UmAlb)、血浆总蛋白(TP)。病例组中53例作眼科临床检查,视力、眼压、裂隙灯检查,裂隙灯下前置镜检查眼底。参照中国眼底协会(1984年)制定的标准对视网膜进行分型、分期。典型病例作前置镜下眼底照相。结果:①糖尿病组与对照组对比,HCY、微量蛋白尿、尿素氮、血肌酐、尿酸无统计学差异;②在所有受检者中,HCY与年龄、性别、肌酐、尿酸有明显相关性;③在对照组,HCY与微量蛋白尿有负相关性,与三酰甘油正相关,与BMI正相关;在糖尿病组无上述相关关系;④糖尿病视网膜病变(DR)程度与空腹血糖、空腹胰岛素正相关;与HCY无明显相关性;⑤两性别组间,BMI、HCY、Cr、UA差异有统计学意义(P<0.05),男性高于女性。结论:高血糖为影响DR发展的明显优势因素,同型半胱氨酸在糖尿病视网膜病变及糖尿病性肾病中的意义尚需进一步研究。

The aged type 2 diabetes serum total homocysteine and diabetic retinopathy

Objective To investigate the relationship of serum total homocysteine(HCY) level and diabetic retinopathy in the aged type 2 diabetes mellitus(DM).Methods 70 cases of type 2 diabetic patients and 42 cases of the control group were measured blood pressure(Bp),body mass index(BMI),homocysteine(HCY),fasting plasma glucose(FPG),fasting insulin(FNS),glycated hemoglobin(GHb),total cholesterol(CHO),tr iglycerides(TG),creatinine(Cr),urea nitrogen(BUN),uric acid(UA),trace proteinuria(UmAlb),plasma total protein(TP).In case group,53 patients were checked ophthalmology clinical examination,eyesight,intraocular pressure and fundus examination under slit lamp with funduspre-setlens.Types and stages of diabetic retinopathy were divided according to the standard made by Chinese eyeground association(1984).Typical cases were made groundphotography.Results Compared with the controls,diabetes show no difference in HCY,UmAlb,BUN,CR and UA.In all cases,HCY correlated positively with age,with gender,with CR,with UA(P<0.05).In the controls,HCY correlated negatively with UmAlb,correlated positively with TG,with BMI;No correlation between HCY and UmAlb in DM patients.Degree of DR correlated positively with FPG,with FNS;and not correlated with HCY.Conclusion High blood glucose is the key factor in development of DR.Whether homocysteine has independent influence in diabetic retinopathy and diabetic nephropathy needs further research.