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.
陈文倩, 王晓雪, 刘慧芳, 杜雯雯, 秦伟, 张丹, 李沭, 李朋梅. 2型糖尿病肾病及非肾病患者同型半胱氨酸及叶酸等9种维生素水平分析[J]. 中国药学杂志, 2020, 55(14): 1154-1157.
CHEN Wen-qian, WANG Xiao-xue, LIU Hui-fang, DU Wen-wen, QIN Wei, ZHANG Dan, LI Shu, LI Peng-mei. Research on Levels of Homocysteine and 9 Kinds of Vitamins Including Folic Acid in Type 2 Diabetic Nephropathy and Non-nephropathy Patients. Chinese Pharmaceutical Journal, 2020, 55(14): 1154-1157.
WANG Y, WU D H, CHENG Y, et al. Clinical value of vitamin D in patients with type 2 diabetes mellitus[J]. China Med(中国医药), 2019, 14(8):1189-1191.
[2]
WU S H, JING Y, HU Y, et al. The blood homocysteine, folic acid and vitamin B12 levels analysis of elderly patients with diabetes[J]. Chin J Clin Healthcare(中国临床保健杂志), 2018, 21(2):196-198.
[3]
NIXW A, ZIRWES R, BANGERT V, et al. Vitamin B status in patients with type 2 diabetes mellitus with and without incipient nephropathy[J]. Diabetes Res Clin Pract, 2015, 107(1):157-165.
[4]
MAO X D, XING X B, XU R, et al. Folic acid and vitamins D and B12 correlate with homocysteine in Chinese patients with type-2 diabetes mellitus, hypertension, or cardiovascular disease[J]. Medicine (Baltimore), 2016, 95(6):e2652.
[5]
JIANG F F. Changes of serum homocysteine and its relationship with IR in patients with type 2 diabetic nephropathy[J]. Guide China Med(中国医药指南), 2018, 16(25):121.
[6]
ZHAO A P, WEI J F, WANG J R, et al. Changes of serum 25-OH vitamin D3 level in diabetic microangiopathy and its influencing factors[J]. J Chin Phys(中国医师杂志), 2019, 21(1):102-104.
[7]
WANG J Y. Correlation analysis of serum cystatin C, glycosylated hemoglobin and homocysteine with early diabetic renal injury[J]. Guide China Med(中国医药指南), 2018, 16(14):113-114.
[8]
YANG P, LIAO P, WU W J. Relationship between serum homocysteine, C-reactive protein and carotid arteries atherosclerosis in patients with type 2 diabetes mellitus complicated with cerebral infarction[J]. China Med Herald(中国医药导报), 2019, 16(5):126-129,141.
[9]
XU X. Correlation between serum vitamin D3 and peripheral neuropathy in elderly patients with type 2 diabetes mellitus[J]. Chin J Gerontol(中国老年学杂志), 2018, 38(12):2850-2852.
[10]
XING C, WANG Y J. Advances in vitamin D and microvascular complications of type 2 diabetes mellitus[J]. J Chin Phys(中国医师杂志), 2019, 21(4):638-641.
[11]
PASTORE A, NOCE A, DI G G, et al. Homocysteine, cysteine, folate and vitamin B12 status in type 2 diabetic patients with chronic kidney disease[J]. J Nephrol, 2015, 28(5):571-576.
[12]
HU R M.Diagnosis and management of diabetic nephropathy[J]. Clin J Diabetes World, 2015, 9(9):447-453.
[13]
The Microvascular Complications Group of Chinaese Diabetes Association. Chinese clinical practice guideline of diabetic kidney disease[J]. Chin J Diabetes(中华糖尿病杂志),2019, 11(1):15-19.