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目的探讨同型半胱氨酸(Hcy)水平在老年2型糖尿病(T2DM)患者合并糖尿病肾病(DN)时的变化及其与DN的关系。方法 58例老年T2DM患者按有无DN分为T2DM组及DN组,测定两组患者的Hcy水平,并与46名健康对照者(对照组)进行比较。结果①DN组血Hcy水平明显高于对照组及T2DM组。DN组高Hcy血症(Hcy>15μmol/L)的发生率为53.0%,较对照组(9.8%)及T2DM组(24.2%)明显升高(P﹤0.05)。②Hcy升高的T2DM患者中尿微量白蛋白排泄率(UAER)、肌酐(Cr)及DN的发生率高于Hcy正常的T2DM患者(P﹤0.05)。③多因素回归分析提示血Hcy水平与DN有关(Hcy与Cr、BUN、UAER呈正相关)。结论 Hcy与老年DN有关,可能是DN发生发展的危险因素之一。
Objective To investigate the changes of homocysteine (Hcy) level in patients with type 2 diabetes mellitus (T2DM) complicated with diabetic nephropathy (DN) and its relationship with DN. Methods Fifty-eight elderly patients with T2DM were divided into T2DM group and DN group according to presence or absence of DN. Hcy levels in both groups were measured and compared with 46 healthy controls (control group). Results ① The level of Hcy in DN group was significantly higher than that in control group and T2DM group. The incidence of Hcy hyperlipidemia (53.0%) in DN group was significantly higher than that in control group (9.8%) and T2DM group (24.2%) (P <0.05). (2) The urinary albumin excretion rate (UAER), creatinine (Cr) and DN were significantly higher in T2DM patients with elevated Hcy than those with normal Hcy (P <0.05). (3) Multivariate regression analysis showed that serum Hcy levels were related to DN (Hcy was positively correlated with Cr, BUN and UAER). Conclusions Hcy is related to elderly DN and may be one of the risk factors for the development of DN.