The Relationship Between Homoeysteine And Abnormal Glucose Metabolism

ObjectiveTo investigate the relationship between homocysteine and islet beta cell function through observe blood plasma homocysteine level and level of islet beta cell function at different stage of sugar tolerance.And to discuss whether blood plasma homocysteine level is correlated with islet beta cell function and insulin resistance.METHODSCollect who come our hospital for physical exam and who seek the treatment in our hospital during period 2010-03 to 2010-12.And devide 128 subjects into four group by oral glucose tolerance test(OGTT).Including 29 normal glucose tolerence(NGT) subjects,32 impaired glucose tolerance(IGT) subjects,35 newly diagnosed patients with T2DM(new T2DM) and 32 patients whose course of type 2 diabetes mellitus is ten years(ten years T2DM).We observe sex, age, height, body weight, smoking, drinking, exercise, hypertensive disease, blood plasma homocysteine, blood fat, fasting blood glucose; glycosylated hemoglobin(HbAlc), insulin, uric acid, urinary microalbumin,carotid artherosclerosis. And calculate homeostasis assessment insulin resistance index (HOMA-IR),homeostasisβcell funtion index (HBCI),fastingβcell funtion index (FBCI). finally, observing blood plasma homocysteine level at different stage of sugar tolerance and using statistical method to discuss the relationship between HCY and Islet Beta Cell Function.Results:The blood plasma homocysteine in four groups is concentrated on natural logarithm. the statistical difference is not found between IGT group and NGT group (P>0.05). Compared with the NGT group,the level of HCY increase significantly in new T2DM group and ten years-T2DM group ((P=0.000, P=0.000)。Compared with the IGT group,the level of HCY increase significantly innew T2DM group and ten years-T2DM group ((P=0.000, P=0.000)。the statistical difference is not found between I new T2DM group and ten years-T2DM group(P>0.05). Compared with the NGT group,the level of fasting blood glucose increase significantly in IGT group, new T2DM group and ten years T2DM group (P<0.05). the level of fasting blood glucose of new T2DM group and ten years T2DM group is higher than IGT group(P<0.05).The statistical difference of level of fasting blood glucose is not found between new T2DM group and ten years T2DM group (P>0.05).The blood plasma insulin, in four groups is concentrated on natural logarithm. Compared with the NGT group,the level of blood plasma insulin increase significantly in IGT group(P<0.05). the level of fasting blood glucose of new T2DM group and ten years T2DM group is lower than NGT group(P<0.05).The statistical difference of level of blood plasma insulin is not found between new T2DM group and ten years T2DM group (P>0.05).Compared with the NGT group,the level of glycosylated hemoglobin increase significantly in IGT group, new T2DM group and ten years T2DM group (P<0.05). the level of glycosylated hemoglobin of new T2DM group and ten years T2DM group is higher than IGT group(P<0.05).The statistical difference of level of glycosylated hemoglobin is not found between new T2DM group and ten years T2DM group (P>0.05).Compared with the NGT group,the level of HOMA-IR increase significantly in IGT group, new T2DM group and ten years T2DM group (P=0.000, P=0.001, P=0.009).The statistical difference is not found between IGT group, new T2DM group and ten years T2DM group (P>0.05).Compared with the NGT group,the level of HBCI decrease significantly in IGT group, new T2DM group and ten years T2DM group (P=0.019, P=0.000, P=0.000). the level of HBCI of new T2DM group and ten years T2DM group is higher than IGT group(P=0.000, P=0.000). Compared with the NGT group,the level of FBCI decrease significantly in new T2DM group and ten years T2DM group (P=0.000, P=0.000). And the level of FBCI of new T2DM group and ten years T2DM group is higher than IGT group(P=0.000, P=0.000).The statistical difference of the level of FBCI is not found between NGT group and IGT group(P>0.05). The statistical difference of the level of HBCI,FBCI is not found between new T2DM group and ten years T2DM group (P>0.05).In Partial correlation analysis, HCY is positively correlated with FPG,HbAlC, HOMA-IR and negatively correlated with FINS, HBCI,FBCI after adjusting for sex,age, smoking,drinking, body mass index, exercise, blood fat, uric acid,and hypertensive disease, urinary microalbumin,carotid artherosclerosis.In multiple stepwise regression analysis, the serum homocysteine level show a significant association with FBCI, cholesterol, HOMA-IR,age.ConclusionThe level of Hcy is correlated with HOMA-IR. The correlation analysis aslo show that HCY is negatively correlated with HBCI,FBCI.We can conclusion that the increasing of HCY is correlated tightly with the decreasing of Islet Beta Cell Function.HCY may be the good appraisal to the decreasing level of island of langerhans Beta cell function clinically.