【摘要】 目的:探讨高同型半胱氨酸(Hcy)血症与2型糖尿病视网膜病变(DR)及胰岛素抵抗(IR)的关系。方法:ELISA法检测125例2型糖尿病患者及50例对照者血浆总Hcy浓度,依据Hcy水平将糖尿病患者再分为高Hcy组和正常Hcy组,比较两组的临床资料。结果:高Hcy组较正常Hcy组空腹血糖(FBG)、糖化血红蛋白(HbA1C)、胰岛素抵抗指数(HOMA-IR)均明显升高(P<0.05)。多元线性逐步回归分析示,FBG、HbA1C、HOMA-IR均为有统计学意义的Hcy决定因素;Logistic回归分析示,DR的发生与Hcy有关。结论:高Hcy水平是DR发生发展的危险因子,与IR相关。更多还原

【Abstract】 Objective: To evaluate the relationship among diabetic retinopathy(DR),insulin resistance(IR) and blood homocysteine(Hcy) and to discuss the influence of amino acid metabolism on the pathogenesis and development of DR and the effect of IR on Hcy.Methods: T2DM group(according to the WHO diagnosis criteria of type 2 diabetes in 1999) with 125 the aged in-patients of endocrinology department was divided into a group with type 2 diabetic retinopathy(DR group,63 cases) and a group without retinopathy complications(NDR group,62 cases).And the DR group was subdivided into background diabetic retinopathy group(BDR,30 cases) and proliferative diabetic retinopathy(PDR,33 cases).Fasting blood glucose(FBG),fasting insulin(FINS),the blood lipids include the total cholesterol(CHO),the triglyceride(TG) et al,were measured for T2DM group and 50 control subjects(CON group).Then those patients with diabetes were divides into high Hcy group(HHcy group) and normal Hcy group,according to the Hcy plasma level.And clinical indicators were compared between the two groups.Hcy was measured with enzyme linked immunosorbent assay by enzymatic reader.HOMA-IR was calculated.All of clinical data were analyzed retrospectively.Results: Plasma total Hcy level was significantly higher in the DR group [(15.78±3.52)μmol·L-1] than in the NDR group [(13.45±2.29) μmol·L-1] and the CON group [(11.91±2.30) μmol·L-1](P<0.01).And it increased with the severity of retinopathy.Compared with the normal Hcy group,patients in the HHcy group had higher levels of FBG,HbA1C and HOMA-IR(P<0.05).By stepwise regression analysis,FBG,HbA1C and HOMA-IR were the decisive and independent factors of plasma Hcy level in type 2 diabetes.DR(yes or not) as dependent variable and age,sex,body mass index(BMI),CHO,TG,HbA1c and HOMA-IR as independent variable,Logistic regression analysis results showed that disease course,HbA1c,and Hcy were correlated with DR and the higher blood Hcy level might be the independent risk factor of DR.Conclusion: High Hcy level may be a risk factor for the occurance and progression of DR and be related to IR.更多还原