Serum Homocysteine Levels And Influencing Factors In Patients With Different Metabolic State Of Blood Glucose

Objective:To learn the serum homocysteine levels and influencing factors in patients with different metabolic state of blood glucose.Methods:400cases of patients with different metabolic state of blood glucose were collected and divided into Normal Glucose Tolerance Group(Group NGT, n=100), Impared Fasting Glucose(Group IFG, n=100), Impared Glucose Tolerance(Group IGT, n=100) and Diabetes Mellitus(Group DM, n=100) according to the diagnostic criteria(WHO,1999) of diabetes mellitus with equal sex ratio. The data of serum homocysteine(HCY), fasting plasma glucose(FPG),2-hour postprandial blood glucose(2hPG), glycosylated hemoglobin Alc(HbAlc), serum creatinine(Scr), blood urea nitrogen(BUN), serum total cholesterol(TC), low-density lipoprotein cholesterol(LDL-c), high densitv lipoprotein cholesterol(HDL-c), triglyceride(TG), morning spots urinary albumin to creatinine ratio(ACR), and systolic blood pressure(SBP), diastolic blood pressure (DBP), waist circumference (WC), body mass index (BMI) were collected and analized. The t-test or SNK-q test were applied to analyze the independent-samples.The linear correlation analysis and stepwise multiple regression analysis were used to The correlation between serum Hey and other variables. α=0.05。Results:The average serum HCY level of Group IFG(18.17±6.24)μmol/l and Group IGT(18.13±7.41)μmol/l were higher than that of Group NGT(10.2±2.53)μmol/l)(P<0.05, correspondingly), the Group DM(26.00±5.89)μmol/l was higher than that of Group NGT, Group IFG and Group IGT(P<0.05, correspondingly). There was no difference between Group IFG and Group IGT (P>0.05), samely the both gender subgroups(P>0.05). The average urinary ACR of Group IFG(37.72±6.55)mg/g and Group IGT(40.92±7.35)mg/g were higher than that of Group NGT(15.95±4.94)mg/g (P<0.05, correspondingly), the Group DM(50.00±5.30)mg/g was higher than that of Group NGT, Group IFG and Group IGT(P<0.05, correspondingly), there was no difference between Group IFG and Group IGT (P>0.05). The average serum TC of Group IFG(4.88±0.50)mmol/l, Group IGT(4.86±0.58)mmol/l and Group DM(4.95±0.41)mmol/l were higher than that of Group NGT(2.45±0.56)mmol/l (P<0.05, correspondingly), there was no difference between Group IFG, Group IGT and Group DM (P>0.05, correspondingly). The average serum LDL-c of Group IFG(2.34±0.44)mmol/l, Group IGT(2.44±0.41)mmol/l and Group DM(2.55±0.60)mmol/l were higher than that of Group NGT(1.50±0.40)mmol/l (P<0.05, correspondingly), there was no difference between Group IFG, Group IGT and Group DM (P>0.05, correspondingly). The average serum TG of Group IFG(2.18±0.97)mmol/l, Group IGT(2.24±0.88)mmol/l and Group DM(2.29±0.51)mmol/l were higher than that of Group NGT(1.90±0.34)mmol/l(P<0.05, correspondingly), there was no difference between Group IFG, Group IGT and Group DM (P>0.05, correspondingly). The average SCR of Group IFG(85.47±13.70)μmol/l, Group IGT(87.10±17.70)μmol/l and Group DM(90.68±16.30)μmol/l were higher than that of Group NGT(63.17±15.40)μmol/l (P<0.05, correspondingly), there was no difference between Group IFG, Group IGT and Group DM (P>0.05, correspondingly). The average BUN of Group IFG(8.02±1.14)mmol/l, Group IGT(8.10±1.44)mmol/l and Group DM(8.38±1.02)mmol/l were higher than that of Group NGT(5.57±1.09)mmol/l (P<0.05, correspondingly), there was no difference between Group IFG, Group IGT and Group DM (P>0.05, correspondingly). The relationship between serum Hey and other indicators within each group By using linear correlation analysis was the following:Group NGT, SCR. BUN and AGE were positiely correlated with Serum Hey (P<0.05, correspondingly). Group IFG,2hPG、HbAlc、WC、ACR and LDL-c、 SCR、BUN and AGE were positively correlated with Serum Hcy(P<0.05, correspondingly). Group IGT,2hPG、HbAlc、WC、ACR、TC and LDL-c、SCR、 BUN and AGE were positively correlated with Serum Hcy(P<0.05, correspondingly). Group T2DM,2hPG、HbAlc、WC、ACR、LDL-c、SCR、BUN、AGE were positively correlated with Serum Hcy(P<0.05, correspondingly). Groups further stepwise multiple regression analysis showing:Group NGT, SCR and BUN existed a significant positive correlation with serum Hey. Group abnormal glucose metabolism (IFG+IGT+T2DM),SCR、BUN、2hPG and LDL-c were a significant positive correlation with Serum Hcy(P<0.05).Conclusions:The serum HCY of patients with both pre-diabetes and the overt diabetes increase significantly. There is a trend that the serum level of HCY increase with the deterioration of blood glucose metabolism. Group abnormal glucose metabolism (IFG+IGT+T2DM),SCR、BUN、2hPG and LDL-c were a significant positive correlation with Serum Hey. Hyperhomocysteinemia should be controled beside for the blood glucoe, blood fat and blood presure during the management of diabetes mellitus.