不同糖耐量患者血浆同型半胱氨酸与血清C反应蛋白的改变

Plasma homocysteine and serum C-reactive protein levels in patients with different glucose intolerance

  • 摘要: 目的: 探讨不同糖耐量阶段血浆同型半胱氨酸(Hcy)与血清C反应蛋白(CRP)的改变及两者的关系。方法: 测定新发糖尿病组(T2DM,30例),糖耐量低减组(IGT,35例),对照组即正常糖耐量组(NGT,40例)血浆Hcy、叶酸、VitB12和血清CRP的水平。Hcy采用免疫荧光偏振法测定,CRP采用酶联免疫法测定,化学发光法测定血浆叶酸、VitB12浓度。结果: NGT、IGT、DM各组中,血清CRP水平逐渐升高(P<0.001),IGT与新发DM组血浆Hcy显著高于NGT组(P<0.01),新发DM组Hcy略高于IGT组,但无统计学差异(P>0.05);叶酸、VitB12水平在NGT、IGT、DM各组中依次减低,且NGT组与IGT、DM组相比,差异有显著性(P<0.05)。相关分析显示Hcy与CRP(r=0.231,P=0.034)、尿Alb/Cr(r=0.327,P=0.001)、FBG(r=0.236,P=0.017)呈显著正相关关系,与叶酸(r=-0.294,P=0.003)、VitB12(r=-0.328,P=0.001)显著负相关。结论: 随着糖耐量的恶化, 血浆Hcy与血清CRP水平逐渐升高, 可能与叶酸、VitB12的缺乏及胰岛素抵抗的加重有关。血浆Hcy与血清CRP, 可能参与了糖耐量异常患者血管病变的发生。

     

    Abstract: Objective: To investigate the changes of plasma homocysteine(Hcy) and serum C reactive protein(CRP) levels in subjects with different glucose tolerance and their relation. Methods: A total of 105 subjects were recruited in this study.Among these subjects,40 were healthy controls with normal glucose tolerance(NGT),35 had impaired glucose tolerance(IGT),30 had newly diagnosed type 2 diabetes mellitus(DM).Plasma Hcy levels were measured by polarization immunoassay(FPIA),serum CRP concentrations were determined by enzymatic linked immunosorbbent assay(ELISA),plasma folic acid and vitamin B12 levels were measured by radioimmunoassay. Results: Plasma Hcy concentrations were significantly higher in patients with IGT and DM than in patients with NGT median(25% and 75%),IGT 7.08(6.45-8.58) μmol/L,DM 8.58(6.97-9.46) μmol/L,NGT 5.64(5.17-8.00) μmol/L,P<0.05).The serum CRP level median(25%,75%) was 0.37(0.18-0.89)mg/L in patients with NGT and 1.34(0.53-2.79) mg/L in patients with IGT,1.66(1.08-2.27)mg/L in patients with type 2 DM(P<0.05) respectively,while folic acid and vitamin B12 levels decreased gradually with the worsening glucose tolerance(P<0.05).Plasma Hcy concentrations were positively correlated with serum CRP and urine Alb/Cr levels((r=0.231,P=0.034;r=0.327,P=0.001,respectively),and negatively correlated with plasma folic acid and vitamin B12 levels(r=-0.294,P=0.003;r=-0.328,P=0.001). Conclusion: With the worsening of glucose tolerance,the Hcy and CRP levels increase gradually.Deficiency in folic acid and vitamin B12 and insulin resistance might be responsible for the increased Hcy and CRP levels in patients with abnormal glucose tolerance.Hcy and CRP might partially account for the increased risk of developing vasculopathy in patients with abnormal glucose tolerance.

     

/

返回文章
返回