摘要【目的】探讨2型糖尿病（T2DM）患者血清总同型半胱氨酸（total homosysteine ，tHcy）对大血管并发症的影响。【方法】收集上海、北京、广东、南京、辽宁、天津、浙江29家三级医院共1441例 T2DM 患者，检测其空腹血清 tHcy水平。同时进行体格检查、血糖、血脂、维生素B6水平的测定。并通过问卷形式获得糖尿病（DM ）并发症等相关信息。【结果】DM大血管并发症的发生率为16．17％（233/1441）。有并发症组中血清tHcy水平为（14．28±8．76）μmol/L显著高于无并发症组的（11．55±5．50）μmol/L（ P＜0．001）。调整年龄和性别后，血清tHcy＞15μmol/L组的DM大血管并发症OR值为2．345（95％ CI 1．665～3．302），冠状动脉并发症OR值为1．932（95％ CI 1．104～3．380），脑血管并发症 OR值为2．056（95％ CI 1．311～3．176），周围血管并发症OR值3．004（95％ CI 1．656～5．450）。【结论】高同型半胱氨酸血症增加 T2DM 患者大血管并发症发生风险。
Abstract：To explore the effect of serum total homocysteine (tHcy ) on macroangiopathy in patients with type 2 diabetes mellitus(T2DM ) .[Methods] Totally 1441 T2DM patients from 29 tertiary grade A hospitals in Shanghai ,Beijing ,Guangdong ,Nanjing ,Liaoning ,Tianjin and Zhejiang were collected .The Fasting serum tHcy was measured .All patients received physical examination .The levels of blood glucose , blood lipids and vitamin B6 were also measured .The related data of diabetic complications were obtained by questionnaire survey .[Results]The incidence rate of diabetic macroangiopathy was 16 .17% (233/1441) .Ser-um tHcy level of the group with complications was (14 .28 ± 8 .76)μmol/L ,which was significantly higher than that of the group without complications[(11 .55 ± 5 .50)μmol/L]( P <0 .001) .After adjustment for age and sex ,the odds ratio(OR) value of diabetic macroangiopathy in the group with serum tHcy >15μmol/L was 2 .345(95% CI 1 .665 to 3 .302) ,and that of diabetic coronary artery diseases was 1 .932(95% CI 1 .104~3 .380) ,and that of diabetic cerebrovascular diseases was 2 .056(95% CI 1 .331~3 .176) ,and that of diabetic peripheral vascular diseases was 3 .004(95% CI 1 .656~5 .450) .[Conclusion] Hyperhomocysteinaemia can in-crease the risk of macroangiopathy in patients with T 2DM .
2014, Vol. 31 
