同型半胱氨酸水平与2型糖尿病患者123I-间碘苄胍心肌闪烁显像结果相关。

Homocysteine levels are associated with the results of 123I-metaiodobenzylguanidine myocardial scintigraphy in type 2 diabetic patients.

作者信息

Anan Futoshi, Yonemochi Hidetoshi, Masaki Takayuki, Takahashi Naohiko, Nakagawa Mikiko, Eshima Nobuoki, Saikawa Tetsunori, Yoshimatsu Hironobu

机构信息

Department of Cardiovascular Science, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Oita, 879-5593, Japan.

出版信息

Eur J Nucl Med Mol Imaging. 2007 Jan;34(1):28-35. doi: 10.1007/s00259-006-0200-9. Epub 2006 Aug 4.

DOI:10.1007/s00259-006-0200-9

PMID:16896659

Abstract

PURPOSE

Elevated total plasma homocysteine (tHcy) levels and cardiovascular autonomic dysfunction are associated with a high mortality in type 2 diabetic patients. We tested the hypothesis that hyperhomocysteinemia is associated with insulin resistance and cardiovascular autonomic dysfunction in type 2 diabetic patients not receiving insulin treatment.

METHODS

The study group consisted of 17 type 2 diabetic patients with high tHcy levels (>15 mmol/l, age 58+/-5 years, high tHcy group). The control group consisted of 23 age-matched type 2 diabetic patients with normal tHcy levels (<or=15 mmol/l, age 58+/-9 years, normal tHcy group). Cardiovascular autonomic function was assessed by baroreflex sensitivity, heart rate variability, plasma norepinephrine concentrations, and cardiac (123)I-metaiodobenzylguanidine (MIBG) scintigraphy.

RESULTS

Early and delayed (123)I-MIBG myocardial uptake values were lower (p<0.005 and p<0.01, respectively) and the percent washout rate of (123)I-MIBG was higher (p<0.001) in the high tHcy group than in the normal tHcy group. The fasting plasma insulin concentrations (p<0.0001) and the homeostasis model assessment (HOMA) index values (p<0.0001) were higher in the high tHcy group than in the normal tHcy group. Multiple regression analysis revealed that the level of tHcy was independently predicted by the HOMA index values and the myocardial uptake of (123)I-MIBG at the delayed phase.

CONCLUSION

Our results demonstrate that high levels of tHcy are associated with depressed cardiovascular autonomic function and insulin resistance in patients with type 2 diabetes mellitus.

摘要

目的

血浆总同型半胱氨酸（tHcy）水平升高及心血管自主神经功能障碍与2型糖尿病患者的高死亡率相关。我们检验了如下假设：在未接受胰岛素治疗的2型糖尿病患者中，高同型半胱氨酸血症与胰岛素抵抗及心血管自主神经功能障碍有关。

方法

研究组由17例tHcy水平较高（>15 mmol/L，年龄58±5岁，高tHcy组）的2型糖尿病患者组成。对照组由23例年龄匹配、tHcy水平正常（≤15 mmol/L，年龄58±9岁，正常tHcy组）的2型糖尿病患者组成。通过压力反射敏感性、心率变异性、血浆去甲肾上腺素浓度及心脏（123）I-间碘苄胍（MIBG）闪烁显像评估心血管自主神经功能。

结果

高tHcy组的早期及延迟（123）I-MIBG心肌摄取值较低（分别为p<0.005和p<0.01），且（123）I-MIBG的洗脱率百分比更高（p<0.001），高于正常tHcy组。高tHcy组的空腹血浆胰岛素浓度（p<0.0001）及稳态模型评估（HOMA）指数值（p<0.0001）高于正常tHcy组。多元回归分析显示，tHcy水平由HOMA指数值及延迟期（123）I-MIBG的心肌摄取独立预测。