Brazionis Laima, Rowley Kevin, Itsiopoulos Catherine, Harper Colin Alexander, O'Dea Kerin
Department of Medicine, University of Melbourne, St. Vincent's Hospital, P.O. Box 2900, Fitzroy, Victoria 3065, Australia.
Diabetes Care. 2008 Jan;31(1):50-6. doi: 10.2337/dc07-0632. Epub 2007 Sep 26.
Homocysteine is an emerging risk factor for cardiovascular and nondiabetic ocular vaso-occlusive diseases. However, studies of the relationship between homocysteine and diabetic retinopathy have reported inconsistent results. The purpose of this study was to evaluate the relationship between plasma total homocysteine concentration and diabetic retinopathy.
We assessed the homocysteine-retinopathy relationship in 168 men and women with type 2 diabetes in a community-based, cross-sectional study. We photodocumented diabetic retinopathy status and measured plasma total homocysteine concentration using a commercial fluorescence polarization immunoassay enzymatic kit. Data for selected clinical/demographic variables and established risk factors for diabetic retinopathy were obtained from fasting blood samples and an interviewer-assisted lifestyle questionnaire.
A higher mean plasma total homocysteine concentration was observed in diabetic individuals with retinopathy than in those without retinopathy (11.5 mumol/l [95% CI 10.4-12.5] vs. 9.6 mumol/l [9.1-10.2], P = 0.001). Furthermore, the relationship between homocysteine and diabetic retinopathy was not explained by renal dysfunction and was independent of the other major risk factors for diabetic retinopathy (duration of diabetes, A1C, and systolic blood pressure) and determinants of higher homocysteine concentrations (age, sex, and red cell folate) (odds ratio 1.20 [95% CI 1.023-1.41], P = 0.024).
Plasma total homocysteine concentration may be a useful biomarker and/or a novel risk factor for increased risk of diabetic retinopathy in people with type 2 diabetes.
同型半胱氨酸是心血管疾病和非糖尿病性眼部血管闭塞性疾病新出现的一个风险因素。然而，关于同型半胱氨酸与糖尿病视网膜病变之间关系的研究报告结果并不一致。本研究的目的是评估血浆总同型半胱氨酸浓度与糖尿病视网膜病变之间的关系。
在一项基于社区的横断面研究中，我们评估了168例2型糖尿病男性和女性的同型半胱氨酸与视网膜病变之间的关系。我们通过拍照记录糖尿病视网膜病变状态，并使用商用荧光偏振免疫分析酶试剂盒测量血浆总同型半胱氨酸浓度。从空腹血样和访员协助的生活方式问卷中获取选定的临床/人口统计学变量数据以及已确定的糖尿病视网膜病变风险因素。
患有视网膜病变的糖尿病患者的平均血浆总同型半胱氨酸浓度高于未患视网膜病变的患者（11.5μmol/L[95%CI 10.4 - 12.5]对9.6μmol/L[9.1 - 10.2]，P = 0.001）。此外，同型半胱氨酸与糖尿病视网膜病变之间的关系不能用肾功能不全来解释，并且独立于糖尿病视网膜病变的其他主要风险因素（糖尿病病程、糖化血红蛋白和收缩压）以及较高同型半胱氨酸浓度的决定因素（年龄、性别和红细胞叶酸）（比值比1.20[95%CI 1.023 - 1.41]，P = 0.024）。
血浆总同型半胱氨酸浓度可能是2型糖尿病患者糖尿病视网膜病变风险增加的一个有用生物标志物和/或新的风险因素。
