中华内科杂志
中華內科雜誌
중화내과잡지
CHINESE JOURNAL OF INTERNAL MEDICINE
2011年
1期
14-17
,共4页
李剑波%成玉泽%石敏%张红曼%戴庆%张瑜%王艳娟%陈继文%王红星%陈家伟
李劍波%成玉澤%石敏%張紅曼%戴慶%張瑜%王豔娟%陳繼文%王紅星%陳傢偉
리검파%성옥택%석민%장홍만%대경%장유%왕염연%진계문%왕홍성%진가위
糖尿病神经病变%高同种半胱氨酸血症%危险因素
糖尿病神經病變%高同種半胱氨痠血癥%危險因素
당뇨병신경병변%고동충반광안산혈증%위험인소
Diabetic neuropathies%Hyperhomocysteinemia%Risk factors
目的 探讨血浆总同型半胱氨酸浓度与糖尿病外周神经病变的关系.方法 入选2型糖尿病患者227例,进行横断面研究.用临床表现及肌电图诊断外周糖尿病神经病变,并测定血浆同型半胱氨酸水平及与糖尿病神经病变相关或可能影响血浆同型半胱氨酸水平的指标.结果 糖尿病外周神经病变患者80例,糖尿病无神经病变者147例.糖尿病神经病变组血浆总同型半胱氨酸水平(12.6±3.6)μmol/L,高于糖尿病非神经病变组(8.2±0.9)μmol/L(P＜0.01).在校正外周神经病变传统危险因素(糖尿病病程、糖化血红蛋白)及高同型半胱氨酸浓度的影响因素(年龄、性别、血清叶酸和维生素B12、肾功能状态和双胍类使用)后,同型半胱氨酸与糖尿病神经病变仍相关[OR1.15(1.02～1.28),P＜0.05].在校正每单位上述混杂因素增加后,每增加4.0 μmol/L的血浆同型半胱氨酸也与神经病变发生密切相关[OR 1.17(0.94～1.33),P＜0.05].结论 高血浆总同型半胱氨酸浓度与糖尿病神经病变的发生相关,为糖尿病外周神经病变的独立危险因素.
目的 探討血漿總同型半胱氨痠濃度與糖尿病外週神經病變的關繫.方法 入選2型糖尿病患者227例,進行橫斷麵研究.用臨床錶現及肌電圖診斷外週糖尿病神經病變,併測定血漿同型半胱氨痠水平及與糖尿病神經病變相關或可能影響血漿同型半胱氨痠水平的指標.結果 糖尿病外週神經病變患者80例,糖尿病無神經病變者147例.糖尿病神經病變組血漿總同型半胱氨痠水平(12.6±3.6)μmol/L,高于糖尿病非神經病變組(8.2±0.9)μmol/L(P＜0.01).在校正外週神經病變傳統危險因素(糖尿病病程、糖化血紅蛋白)及高同型半胱氨痠濃度的影響因素(年齡、性彆、血清葉痠和維生素B12、腎功能狀態和雙胍類使用)後,同型半胱氨痠與糖尿病神經病變仍相關[OR1.15(1.02～1.28),P＜0.05].在校正每單位上述混雜因素增加後,每增加4.0 μmol/L的血漿同型半胱氨痠也與神經病變髮生密切相關[OR 1.17(0.94～1.33),P＜0.05].結論 高血漿總同型半胱氨痠濃度與糖尿病神經病變的髮生相關,為糖尿病外週神經病變的獨立危險因素.
목적 탐토혈장총동형반광안산농도여당뇨병외주신경병변적관계.방법 입선2형당뇨병환자227례,진행횡단면연구.용림상표현급기전도진단외주당뇨병신경병변,병측정혈장동형반광안산수평급여당뇨병신경병변상관혹가능영향혈장동형반광안산수평적지표.결과 당뇨병외주신경병변환자80례,당뇨병무신경병변자147례.당뇨병신경병변조혈장총동형반광안산수평(12.6±3.6)μmol/L,고우당뇨병비신경병변조(8.2±0.9)μmol/L(P＜0.01).재교정외주신경병변전통위험인소(당뇨병병정、당화혈홍단백)급고동형반광안산농도적영향인소(년령、성별、혈청협산화유생소B12、신공능상태화쌍고류사용)후,동형반광안산여당뇨병신경병변잉상관[OR1.15(1.02～1.28),P＜0.05].재교정매단위상술혼잡인소증가후,매증가4.0 μmol/L적혈장동형반광안산야여신경병변발생밀절상관[OR 1.17(0.94～1.33),P＜0.05].결론 고혈장총동형반광안산농도여당뇨병신경병변적발생상관,위당뇨병외주신경병변적독립위험인소.
Objective To explore the relationship between plasma homocysteine levels and diabetic peripheral neuropathy (DPNP). Methods A crossectional analysis was conducted on 227 patients with type 2 diabetes. Peripheral neuropathy was confirmed using electromyography (EMG). The risk factors possibly associated with diabetic neuropathy or plasma homocysteine levels were analyzed in relation to likelihood of occurrence of DPNP. Results Eighty patients with neuropathy and 147 patients without neuropathy were included. Plasma homocysteine levels were significantly higher in patients with diabetic neuropathy [( 12. 6 ± 3.6 ) μmol/ L] than without diabetic neuropathy [( 8. 2 ± 0. 9 ) μmol/L] ( P ＜0. 001 ), and the relationship remained significant after adjusting for duration of diabetes, glycosylated hemoglobin A1c (HbA1c), age, renal status, serum folate acid and vitamin B12, and metformin [OR 1.15( 1.02-1.28 ) ,P ＜ 0. 05]. In addition, per increase of 4. 0 μmol/L plasma homocysteine was closely related to the occurrence of neuropathy after controlling for per unit increase of other confounding factors [OR 1.17(0. 94-1.33), P ＜ 0. 05]. Conclusions Hyperhomocysteinemia was an independent risk factor for the occourence of diabetic peripheral neuropathy.
