秦怀波 陈云 俞丽萍 孙水云

　　作者单位：655000云南省曲靖市第二人民医院综合科

　　【摘要】 目的 探讨2型糖尿病(T2DM)患者不同血糖状态及降血糖治疗对血浆同型半胱氨酸(Hcy)水平的影响。 方法 对225例无明确并发症和合并症的T2DM患者，分别测定FPG、2hPG、血脂、血浆Hcy。其中病程3个月内患者43例，进行药物等综合降血糖治疗3个月后再检测以上指标。统计分析血糖控制水平及随访前后糖脂指标变化和Hcy的关系。 结果 血糖控制良好的患者血浆Hcy水平较血糖控制差的显著降低(14.10±3.92 vs 15.44±4.28, P<0.05);新诊断的患者治疗后血浆Hcy水平也较治疗前显著降低(14.18±2.26 vs 15.25±2.41, P<0.01)，血糖控制较好的患者血浆Hcy水平仍较正常人偏高。相关分析显示，血浆Hcy水平主要与FPG和HbA1c正相关(分别r=0.193，0.274, P<0.01)。 结论 糖尿病患者的血浆Hcy水平升高，良好控制血糖，可以降低血浆Hcy浓度。

　　【关键词】同型半胱氨酸;糖尿病，2型;降糖治疗

　　doi:10.3969/j.issn.1006-6187.2011.02.010

　　The relationship of plasma homocysteine concentration with improvement of blood glucose and lipid profiles in type 2 diabetes mellitus

　　QIN Huai-bo, CHEN Yun, YU Li-ping, et al.

　　Department of Internal Medicine, Comprehensive branch, QuJing Second People’s Hospital, Yunnan Qujing 655000, China

　　【Abstract】 Objective To study the effect of lowering blood glucose and lipids on plasma homocyteine concentration. Method 225 type 2 diabetic patients without definite diabetic complications received the assays of blood glucose, lipids and Hcy. They were divided into two groups: HbA1c>7% and ≤7% group. The 43 of 225 cases with diabetic course shorter than 3 months were re-evaluated by above parameters after 3 months of hypoglycemic treatment to observe the relationship of blood glucose and lipids control with plasma homocyteine concentration. Result Plasma homocyteine concentration was significant lower in HbA1c≤7% group than in HbA1c>7% group (14.10±3.92 vs 15.44±4.28, P<0.05). After 3 months hypoglycemic treatment the Hcy concentration was significantly decreased as compared with pretreatment (14.18±2.26 vs 15.25±2.41, P<0.001). Hcy was related to FPG and HbA1c. Conclusion The plasma homocyteine concentration is increased in diabetic patients versus healthy control. The plasma homocyteine is associated with blood glucose control.

　　【Key words】Homocyteine; Diabetes mellitus, type 2; Hypoglycemic treatment