Fotiou Pandelis, Raptis Athanasios, Apergis George, Dimitriadis George, Vergados Ioannis, Theodossiadis Panagiotis
2nd Department of Ophthalmology, "Attikon" University Hospital, Athens University Medical School, 1 Rimini Street, 12462 Athens, Greece.
2nd Department of Internal Medicine-Propaedeutic, Research Institute and Diabetes Center, "Attikon" University Hospital, Athens University Medical School, 1 Rimini Street, 12462 Athens, Greece.
J Diabetes Res. 2014;2014:807209. doi: 10.1155/2014/807209. Epub 2014 Jun 10.
We investigated the association of serum homocysteine levels and vitamin status with type 2 diabetic retinopathy. This study included 65 patients with and 75 patients without diabetic retinopathy. Patients with diabetic retinopathy had significantly higher serum homocysteine levels (P < 0.001), higher prevalence of hyperhomocysteinemia (P < 0.001), lower serum folic acid (P < 0.001), and vitamin B12 (P = 0.014) levels than those without diabetic retinopathy. Regression analysis revealed that homocysteine was an independent risk factor for diabetic retinopathy and there was a threshold in its serum level (13.7 μ mol/L), above which the risk of diabetic retinopathy greatly increases (OR = 1.66, P = 0.001). Folic acid was associated with decreased odds for diabetic retinopathy (OR = 0.73, P < 0.001). There was a threshold in serum vitamin B12 level (248.4 pg/mL), below which serum homocysteine concentration significantly increases with decreasing serum vitamin B12 (P = 0.003). Our findings suggest that hyperhomocysteinemia is an independent risk factor for the development and progression of diabetic retinopathy. Decreased serum levels of folic acid and vitamin B12, through raising serum homocysteine concentrations, may also affect the diabetic retinopathy risk.
我们研究了血清同型半胱氨酸水平和维生素状态与2型糖尿病视网膜病变之间的关联。本研究纳入了65例患有糖尿病视网膜病变的患者和75例未患糖尿病视网膜病变的患者。与未患糖尿病视网膜病变的患者相比，患有糖尿病视网膜病变的患者血清同型半胱氨酸水平显著更高（P < 0.001），高同型半胱氨酸血症患病率更高（P < 0.001），血清叶酸水平更低（P < 0.001），维生素B12水平更低（P = 0.014）。回归分析显示，同型半胱氨酸是糖尿病视网膜病变的独立危险因素，其血清水平存在一个阈值（13.7 μmol/L），高于该阈值，糖尿病视网膜病变的风险大幅增加（OR = 1.66，P = 0.001）。叶酸与糖尿病视网膜病变的患病几率降低相关（OR = 0.73，P < 0.001）。血清维生素B12水平存在一个阈值（248.4 pg/mL），低于该阈值，血清同型半胱氨酸浓度会随着血清维生素B12水平的降低而显著升高（P = 0.003）。我们的研究结果表明，高同型半胱氨酸血症是糖尿病视网膜病变发生和进展的独立危险因素。血清叶酸和维生素B12水平降低，通过升高血清同型半胱氨酸浓度，可能也会影响糖尿病视网膜病变的风险。
