Effects Of Vitamin B12 And Folic Acid Combined With Metformin On Homocysteine In Patients With Type 2 Diabetes Mellitus

Objective:To analyze the relationship between homocysteine?Hcy?and type 2 diabetes mellitus?T2DM?,and to observe the effects of vitamin B₁₂(Vit B₁₂)and folic acid?FA?combined with metformin on homocysteine in patients with type 2 diabetes mellitus.Methods:In the analysis of the role of Hcy in the occurrence and development of T2DM,96cases of T2DM were divided into observation group,43 cases of T2DM nephropathy and53 cases of the control group,T2DM alone,40 healthy subjects were selected as normal control group;take T2DM nephropathy as two classification variables,through discussing the relationship between T2DM nephropathy and Hcy,analysis of the role of Hcy in the occurrence and development of T2DM,and carry out Logistic regression analysis;In the study of the effect of vitamin B₁₂ and folic acid combined with metformin on homocysteine in type 2 diabetes mellitus,160 patients with type 2 diabetes were randomly divided into A group,B group,C group and D group according to admission order.Group A was treated with metformin and group B was treated with metformin and vitamin B₁₂,Group C received metformin combined with folic acid,and group D received metformin combined with vitamin B₁₂ and folic acid.The changes of homocysteine,vitamin B₁₂,folic acid and homocysteine were analyzed before and after treatment in group A,B,C and D,respectively.Result:The levels of homocysteine in control group,control group and observation group were significantly higher than those in control group and control group?P<0.05?.?2?The levels of homocysteine in normal control group,control group and observation group were significantly higher than those in control group?P>0.05?.the observation group in age,systolic blood pressure TG levels were significantly higher than normal control group,the control group,the difference was statistically significant?P<0.05?;in the observation group HDL and APO-A1 were significantly lower than the normal control group,the difference was statistically significant?P<0.05?,but compared with the control group,the difference was not statistically significant?P>0.05?;3,with or without the occurrence of type 2 diabetic nephropathy as dichotomous strain,the analysis shows that systolic blood pressure,homocysteine can be the independent Risk factors of T2DM;4,Spearman correlation analysis shows that homocysteine was postively correlated with and systolic blood pressure,triglyceride,fasting plasma glucose,apolipoprotein B,and was negatively correlated with HDL-C.?P<0.05?,;5.The levels of homocysteine was negatively correlated vitamin B12 and folic acid?P<0.05?,;6.After treatment,the levels of vitamin B12 and folic acid decrease in group A,while the levels of homocysteine increase in group A.?P<0.05?,.The levels of vitamin B₁₂ increase in group B,while the levels of folic acid and homocysteine decrease in group B?P<0.05?,.The levels of folic acid increase in group C,while the levels of vitamin B12 and homocysteine decrease in group C?P<0.05?,.The levels of vitamin B12 and folic acid increase in group D,while the level of homocysteine decrease in group A?P<0.05?,.The difference of level of homocysteine in group B,C and D were significantly higher than those in group A?P<0.05?,,and the difference of the level of homocysteine in group D was significantly higher than group B and group C?P<0.05?,.Conclusion:Hcy may participate in the occurrence and development of T2DM,as an important indicator to reflect the severity of the disease,curative effect and prognosis,and simple metformin treatment of type 2 diabetes can cause homocysteine level rise,Combined vitamin B₁₂ and folic acid treatment,can reduce the level of homocysteine,the effect is better than alone with vitamin B12 or folic acid.