目的 对2型糖尿病患者同型半胱氨酸(Hcy)及叶酸等9种维生素水平进行分析,为糖尿病肾病的早期发现及干预提供依据。方法 研究纳入了416例2型糖尿病患者,分为肾病组及非肾病组,纳入同期体检人群作为对照组,并以年龄筛选出老年体检组,回顾性收集研究对象的血清Hcy、叶酸及维生素(Vit)A、D、E、B1、B2、B6、B12和C水平,以单因素方差分析对疾病组及体检组的各项指标进行比较,Pearson相关性分析分析各项指标与肾小球滤过率(GFR)和尿白蛋白/肌酐比值(ACR)的相关性。结果 疾病组的Vit D、B1、B2、B12和C水平与体检组存在显著性差异(P<0.05),但与老年体检组相比,仅Vit D水平下降、Vit B12则呈升高趋势(P<0.05)。肾病与非肾病组的比较中,Hcy及Vit A、D、E、B6水平存在差异(P<0.05),但不能排除肾病组年龄的影响。Hcy及Vit A、D水平与GFR、ACR存在显著相关性(P<0.01)。结论 Hcy与糖尿病肾病发生存在相关性,可作为早期发现糖尿病肾病的参考指标。糖尿病患者中叶酸及Vit B2、B6、B12、C等水溶性维生素已得到有益补充,但脂溶性Vit A、D、E等与肾病发生表现出不同程度的相关,此类维生素的补充可能使患者获益。
Abstract
OBJECTIVE To analyze the levels of homocysteine, 9 kinds of vitamins including folic acid in patients with type 2 diabetes mellitus, so as to provide basis for the early detection and intervention of diabetic nephropathy. METHODSE A total of 416 patients with type 2 diabetes were divided into nephrotic group and non-nephrotic groups, and subjects were included in the same period of physical examination as the physical examination group. The elderly physical examination group was selected by age. The serum homocysteine (Hcy), folic acid and vitamin (Vit) A, D, E, B1, B2, B6, B12 and C levels of all subjects were collected retrospectively. Differences between different groups were analyzed by ANOVA, and Pearson correlation analysis was used to analyze the correlation between different index levels and GFR or ACR. RESULTS The levels of folic acid, and Vit D, B1, B2, B12 and C in the disease groups were significantly different from those in the physical examination group, but only Vit D levels decreased and Vit B12 levels increased comparing with those in the elderly physical examination group (P<0.05). There were differences in Hcy, and Vit A, D, E and B6 levels between nephrotic group and non-nephrotic group (P<0.05). The changes of these indexes may be related to the occurrence of nephrosis, but the influence of age cannot be excluded. Hcy, Vit A and D levels were significantly correlated with GFR and ACR (P<0.01). CONCLUSION Hcy is related to the occurrence of nephropathy, which may be a reference index for early detection of diabetic nephropathy. Folic acid, Vit B2, B6, B12, C and other water-soluble vitamins have been taken as supplymentin diabetic patients. Fat soluble such as Vit A, D, and E also related to the occurrence of nephropathy in varying degrees, and the supplement of these vitamins may benefit.
关键词
2型糖尿病 /
糖尿病肾病 /
同型半胱氨酸 /
叶酸 /
维生素B /
脂溶性维生素
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Key words
type 2 diabetes /
diabetic nephropathy /
homocysteine /
folic acid /
vitamin B /
fat soluble vitamin
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中图分类号：
R95
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参考文献
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