【摘要】 目的::探讨糖尿病病人血浆同型半胱氨酸(homocysteine,Hcy)浓度与糖尿病周围神经病变(diabetic peripheral neuropathy,DPN)的关系,为糖尿病病人早期预测和有效治疗DPN提供理论依据。方法:选取苏州大学附属第三医院2015年9月至2016年9月初次诊断为2型糖尿病的病人112例,参照肌电图和神经症状评分(NSS),分为有DPN组(n=54)和无DPN组(n=58);选取同期在本院行健康体检者共40例为对照组,通过测定和比较各组Hcy、空腹血糖、肌酐(creatinine,Cr)、总胆固醇(total cholesterol,TC)、三酰甘油(triglycerides,TG)、低密度脂蛋白胆固醇(low density lipoprotein cholestorol,LDL-C)、高密度脂蛋白胆固醇(high density lipoprotein cholestorol,HDL-C)、维生素B12、叶酸等的浓度,研究DPN与Hcy的相关性以及糖尿病病人血浆Hcy浓度的影响因素。结果:有DPN组和无DPN组血浆Hcy浓度明显高于对照组(P<0.01),且有DPN组Hcy浓度明显高于无DPN组(P<0.01)。Logistic逐步回归分析表明,DPN的严重程度与血浆Hcy浓度、病程以及血清HDL-C浓度相关,OR分别为6.883、3.921、7.260;血清高浓度维生素B12、叶酸、HDL-C可作为糖尿病病人Hcy浓度的保护因素,长病程及血清高浓度LDL-C则为危险因素。结论:血浆Hcy浓度可作为DPN的一个预测因子,可通过提高血清叶酸和维生素B12浓度,降低糖尿病病人血浆Hcy浓度,延缓DPN的发生与发展。更多还原

【Abstract】 Objective:To investigate the correlation between plasma concentration of homocysteine(Hcy)and diabetic peripheral neuropathy(DPN)in the patients with type 2 diabetes,so as to provide theoretical evidence for early prediction and effective treatment of DPN.Methods:A total of 112 patients initially diagnosed as type 2 diabetes in the Third Hospital Affiliated to Soochow University from September,2015 to September,2016 were selected for the study.The patients were divided into the DPN group(n=54)and the non-DPN group(n=58)according to electromyography and neurological scores(NSS).During the same period,40 healthy adults who had a medical examination in the hospital were enrolled as the control group.The concentrations of Hcy,fasting plasma glucose,creatinine,total cholesterol,triglycerides,low density lipoprotein cholestorol(LDL-C),high density lipoprotein cholesterol(HDL-C),vitamin B12 and folic acid in the patients of the 3 groups were determined and compared to study the correlation between DPN and Hcy and the influential factors of plasma Hcy concentrations in diabetic patients.Results:The plasma Hcy concentrations of the patients in the DPN group and the non-DPN group were significantly higher than those in the control group(P<0.01),and the plasma Hcy concentrations of the patients in the DPN group were also obviously higher than those in the non-DPN group(P<0.01).Logistic regression results showed that the severity of DPN was correlated with plasma concentrations of Hcy(OR=6.883),course of disease(OR=3.921)and serum concentrations of HDL-C,with OR being 6.883,3.921 and7.260,respectively.High plasma concentrations of folic acid,vitamin B12 and HDL-C were protective factors for the patients with diabetes mellitus,and long disease course and high serum concentration of LDL-C were obvious risk factors.Conclusion:Plasma Hcy concentration could be used as a predictor for DPN.The occurrence and development of DPN could be delayed through the access of increasing the concentrations of folic acid and vitamin B12 and decreasing plasma Hcy in diabetic patients.更多还原