Akademie für Ärztliche Fortbildung in Rheinland-Pfalz, Mainz, Germany.
Private Practice, Daun, Germany.
Diabetes Res Clin Pract. 2015 Jan;107(1):157-65. doi: 10.1016/j.diabres.2014.09.058. Epub 2014 Oct 8.
To investigate the vitamin B status, with particular focus on vitamin B6, in adults with and without incipient nephropathy secondary to type 2 diabetes mellitus.
Plasma and/or urine concentrations of vitamins B₆, B₁, B₁₂, related vitamers and biomarkers (including total homocysteine, methylmalonic acid) were measured in 120 adults with type 2 diabetes (including 46 patients with microalbuminuria) and 52 non-diabetic control subjects.
Plasma concentrations of pyridoxal 5'-phosphate (PLP) were significantly lower in patients with type 2 diabetes than in control subjects (median: 22.7 nmol/L, diabetes with microalbuminuria; 26.8 nmol/L, diabetes without microalbuminuria; 39.5 nmol/L, non-diabetic control; p<0.0001). The prevalence of low PLP (<30 nmol/L) was 63%, 58%, and 25% in the diabetes groups with and without microalbuminuria and the control group, respectively. Plasma levels of pyridoxine and pyridoxal were also lower (p<0.0001), but levels of pyridoxamine, pyridoxamine 5'-phosphate, and pyridoxic acid were higher in both groups with diabetes compared to the control group (p<0.001). Thiamine deficiency was highly prevalent in all groups, whereas low vitamin B₁₂ and elevated methylmalonic acid were rare. Increased levels of C-reactive protein and soluble vascular cell adhesion molecule-1 were observed in the groups with diabetes (p<0.05, versus healthy control).
Deficiency of vitamin B₆ (PLP, pyridoxine, pyridoxal) and vitamin B₁ (thiamine) was prevalent in type 2 diabetes. Incipient nephropathy was associated with more pronounced alterations in vitamin B₆ metabolism and stronger indications of endothelial dysfunction and inflammation.
研究 2 型糖尿病继发初期肾病患者及无该病患者的维生素 B 状态，重点研究维生素 B6。
检测 120 例 2 型糖尿病患者（包括 46 例微量白蛋白尿患者）和 52 例非糖尿病对照者的血浆和（或）尿液中维生素 B₆、B₁、B₁₂、相关维生素类似物和生物标志物（包括总同型半胱氨酸、甲基丙二酸）的浓度。
与对照组相比，2 型糖尿病患者的血浆吡啶醛 5'-磷酸（PLP）浓度显著降低（中位数：22.7 nmol/L，伴微量白蛋白尿的糖尿病；26.8 nmol/L，不伴微量白蛋白尿的糖尿病；39.5 nmol/L，非糖尿病对照；p<0.0001）。伴和不伴微量白蛋白尿的糖尿病组以及对照组中低 PLP（<30 nmol/L）的患病率分别为 63%、58%和 25%。两组糖尿病患者的血浆吡哆醇和吡哆醛水平也较低（p<0.0001），但吡哆胺、吡哆胺 5'-磷酸和吡哆醛酸的水平均高于对照组（p<0.001）。所有组均存在严重的硫胺素缺乏，而维生素 B₁₂ 缺乏和甲基丙二酸升高则较为少见。糖尿病组的 C 反应蛋白和可溶性血管细胞黏附分子-1水平升高（p<0.05，与健康对照组相比）。
2 型糖尿病患者中存在维生素 B₆（PLP、吡哆醇、吡哆醛）和维生素 B₁（硫胺素）缺乏。初期肾病与维生素 B₆ 代谢更明显的改变以及更强的内皮功能障碍和炎症迹象相关。
