摘要
目的探讨老年2型糖尿病患者血清总同型半胱氨酸(tHcy)水平与不同程度肾病和胰岛素抵抗的关系。方法测定98例老年2型糖尿病患者和36例健康对照者血清tHcy及血糖、血脂、肾功能、胰岛素等指标。结果(1)糖尿病组血清tHcy显著高于对照组[(172±76)μmol/L对(94±35)μmol/L,P<001],糖尿病组tHcy水平随着肾病程度的加重而升高,其中肾功能受损组显著高于无肾病组[(286±79)μmol/L对(157±63)μmol/L,P<0001];(2)与正常tHcy组比较,高tHcy组的年龄、尿酸、肌酐、胰岛素抵抗指数(HomaIR)均显著升高(P<005),肌酐清除率(Ccr)显著降低(P<001);(3)相关分析显示,糖尿病患者血清tHcy水平与肌酐、尿酸、HomaIR、年龄均呈显著正相关,与Ccr呈显著负相关。结论老年糖尿病患者高tHcy血症是肾功能减退及胰岛素抵抗的两个重要相关因素。
Objective To investigate the impact of renal function and insulin resistance on serum total homocysteine(tHcy) levels in aged diabetic patients with nephropathy. Methods Serum tHcy, blood glucose, lipids, renal function, serum insulin were measured for 98 elderly patients with type 2 diabetes and 36 normal control subjects. Results (1) Serum tHcy levels were significantly higher in diabetic group than in control group [(17.2±7.6) μmol/L vs (9.4±3.5)μmol/L,P<0.01]. Serum tHcy level of the diabetic group was significantly increased in pace with the deteriolation of nephropathy [(15.7±6.3) vs (28.6±7.9) μmol/L], the subgroup without nephropathy vs the subgroup with impaired renal function, P<0.001). (2) Compared with the normal tHcy levels, the parameters such as age, serum uric acid, serum creatinine and insulin resistance index (Homa-IR) were markedly higher and creatinine clearance(Ccr) markedly lower in thoes high tHcy levels (P<0.05 or <0.01). (3)In the simple regression analyses, tHcy was correlated positively with serum creatinine, serum uric acid and Homa-IR as well as age and negatively with Ccr in all diabetic patients. Conclusions Renal function and insulin resistance are two important determinants of tHcy levels in elderly patients with type 2 diabetes.
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2005年第1期12-14,共3页
Chinese Journal of Geriatrics
