【摘要】 目的探讨2型糖尿病早期肾病患者血清总同型半胱氨酸(THCY)浓度的变化,并分析其影响因素和临床意义。方法应用荧光偏振免疫发光法测定血清THCY浓度。结果①2型糖尿病微量白蛋白尿组血清THCY水平明显高于正常白蛋白尿组和正常对照组(P=0.013,P=0.024),正常白蛋白尿组血清THCY水平与正常对照组相比差异无显著性(P=0.644);②经多元逐步回归分析,CCR、TG是糖尿病患者血清THCY浓度的独立影响因素,血清THCY浓度和DM病程是尿白蛋白排泄率(UAER)的独立影响因素。结论①2型糖尿病微量白蛋白尿患者血清THCY浓度升高,CCR是血清THCY浓度的独立影响因素;②高HCY血症与2型DM早期肾病的发生、发展有关。更多还原

【Abstract】 Objective To investigate the change of serum total homocysteine in type 2 diabetics with incipient diabetic nephropathy and its clinical significance.Methods Serum tHCY levels were measured by fluorescence polarization immunoassay(FPIA) in 60 patients with type 2 diabetes and 30 healthy control subjects.The relationship between tHCY and FPG,HbA1c,FINS,Homa IR,SCr,CCr,TG,TC or UA was analysed.Results ①The serum tHCY level was higher in patients with type 2 diabetes mellitus with microalbuminuria than that in patients with normoalbuminuria and that in control subjects[(11.62±4.26)μmol/L vs(9.73±2.41)μmol/L,P=0.013;(11.62±4.26)μmol/L vs(9.34±2.64)μmol/L,P=0.024],while the serum tHCY level in patients with normoalbuminuria was similar to that in control subjects[(9.73±2.41)μmol/L vs(9.34±2.64)μmol,P=0.644].②By stepwise regression analysis,CCr and TG were independent contributors to serum tHCY level in type 2 diabetes,while serum tHCY and durations of DM were independent contributors to UAER in type 2 diabetes.Conclusions ①Patients with type 2 diabetes with microalbuminuria had an elevated tHCY level.CCr was independent contributor to serum tHCY level.②Hyperhomocysteinemia was related to the development of incipient diabetic nephropathy.更多还原