摘要
目的探讨同型半胱氨酸(Hcy)对2型糖尿病视网膜病变(DR)发生、发展的影响,及其与胰岛素抵抗的关系。方法检测144例2型糖尿病(T2DM)患者及50例同期健康体检者血浆总Hcy(tHcy)浓度及空腹血糖(FBG)、空腹胰岛素(FINS)、糖化血红蛋白(HbA1c)、血脂等,计算胰岛素抵抗指数(HOMA-IR)。对上述临床资料进行回顾性研究。结果视网膜病变组(DR组)血浆tHcy水平高于非视网膜病变组(NDR)组及对照组(P<0.01);增殖型视网膜病变组(PDR组)tHcy水平高于背景型视网膜病变组(BDR组)(P<0.05);多元线性逐步回归分析显示:FBG、HbA1C、HOMA-IR均为有显著意义的tHcy决定因素。结论血浆tHcy水平升高是糖尿病视网膜病变发生、发展的一个重要的危险因子,与胰岛素抵抗相关。
【Objective】To discuss the influence of homocysteine（Hcy） on the pathogenesis and development of diabetic retinopathy（DR） and to evaluate the relationship between blood Hcy and insulin resistance（IR） in patients with DR.【Methods】In T2DM group,144 in-patients of Endocrinology Department were divided into a group with type 2 diabetic retinopathy（DR,72 cases） and a group without retinopathy complications（NDR,72 cases）.The DR group was subdivided into background diabetic retinopathy group（BDR,40 cases） and proliferative diabetic retinopathy（PDR,32 cases）.Fifty persons were served as control group（CON）.Fasting blood glucose（FBG）,fasting insulin（FINS）,the blood lipids include the total cholesterol（CHO）,the triglyceride（TG） et al,were measured for 144 type 2 diabetes and 50 normal control subjects.HOMA-IR was calculated.Those clinical data were analyzed retrospectively.【Results】①Plasma total Hcy levels were significantly higher in DR group [（15.89±3.61） μmol/L] than those in NDR group [（14.07±3.48） μmol/L] and CON group [（11.91±2.3 0） μmol/L]（P 0.05）.②In DR group,plasma tHcy was significantly higher in proliferative diabetic retinopathy（PDR） group than that in background diabetic retinopathy（BDR） group [（16.75±2.41） μmol/L vs（14.31±2.57） μmol/L,P 0.05].③By stepwise regression analysis,FBG,HbA1C and HOMA-IR were the decisive and independent factors for serum Hcy level in type 2 diabetes.【Conclusion】It is suggested that hyperhomocysteinemia may be a risk factor for the development and progression of type 2 diabetic retinopathy and is related with insulin resistance.
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2010年第6期868-871,共4页
China Journal of Modern Medicine
