Endocrinology and Metabolism Department, The First Affiliated Hospital of Nanjing Medical University, Guangzhou Road 300, Nanjing 210029, China.
Diabetes Res Clin Pract. 2011 Jul;93(1):38-42. doi: 10.1016/j.diabres.2011.03.020. Epub 2011 Apr 9.
To explore the relationship between plasma total homocysteine concentration and diabetic neuropathy in Chinese patients with type 2 diabetes.
Chinese patients with type 2 diabetes (n=249) were enrolled in a cross-sectional hospital based study. Diabetic neuropathy status was documented by presence of clinical signs and confirmed by electromyography. Plasma total homocysteine concentration was measured using fluorescence polarization immunoassay. Traditional risk factors for diabetic neuropathy were obtained from fasting blood samples and interviewer-questionnaire.
Plasma total homocysteine levels were higher in subjects with diabetic neuropathy than without (12.8 (9.2-14.8) μmol/l vs. 8.0 (7.7-9.1) μmol/l, p=0.005). The association of homocysteine with diabetic neuropathy was independent of major traditional risk factors for diabetic neuropathy (duration of diabetes, HbA1c) and determinants of higher homocysteine concentration (age, gender, serum folate and vitamin B12, renal status, and Biguanide use) (OR: 1.12 (1.00-1.25), p=0.042). Furthermore, per increase of 4.0 μmol/l plasma homocysteine was related to neuropathy, after controlling for per unit increase of other factors (OR: 1.17 (0.94-1.33), p=0.045).
Plasma total homocysteine concentration was independently associated with occurrence of diabetic neuropathy in Chinese people. Future prospective studies are warranted to clarify the relationship.
探讨中国 2 型糖尿病患者血浆总同型半胱氨酸浓度与糖尿病周围神经病变的关系。
本研究采用横断面医院基础研究,纳入 249 例中国 2 型糖尿病患者。通过临床体征记录并结合肌电图检查来确定糖尿病周围神经病变的情况。采用荧光偏振免疫法测定血浆总同型半胱氨酸浓度。通过空腹血样和问卷调查获取糖尿病周围神经病变的传统危险因素。
与无糖尿病周围神经病变者相比,合并糖尿病周围神经病变者的血浆总同型半胱氨酸水平更高(12.8(9.2-14.8)μmol/L 比 8.0(7.7-9.1)μmol/L,p=0.005)。同型半胱氨酸与糖尿病周围神经病变的相关性独立于糖尿病周围神经病变的主要传统危险因素(糖尿病病程、HbA1c)和同型半胱氨酸浓度升高的决定因素(年龄、性别、血清叶酸和维生素 B12、肾功能以及双胍类药物的使用)(OR:1.12(1.00-1.25),p=0.042)。进一步校正其他因素每单位增加后,血浆同型半胱氨酸每增加 4.0 μmol/L 与神经病变相关(OR:1.17(0.94-1.33),p=0.045)。
在中国人群中,血浆总同型半胱氨酸浓度与糖尿病周围神经病变的发生独立相关。未来需要前瞻性研究来阐明两者的关系。