The significance and risk factor analysis of homocysteine in diabetic patients with macroangiopathy / 中华检验医学杂志

ABSTRACT

Objective To investigate the significance of serum homocysteine (HCY) level in the patients with diabetic macroangiopathy, and analyze the related risk factors.Methods Case control study.279 diabetics (male 198, female 111) aged 59.6(55.0-67.0) were selected in Shanghai Zhongshan Hospital from May 2015 to February 2016.According to the medical history and Carotid intima-media thickness, they were divided into carotid artery disease group (137 cases), cardiovascular disease group (197 cases) and cerebrovascular disease group (29 cases).We detected veinal blood HCY , fasting blood glucose, glycated albumin, total bilirubin, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, L-, gamma glutamyl transferase, urea nitrogen, creatinine, uric acid, cholesterol, three triglyceride, high density lipoprotein cholesterol, low density lipoprotein cholesterol, glycosylated hemoglobin and albumin , creatinine in urine.The groups were compared with Mann-Whitney U test and χ2 test;Pearson correlation analysis was used to determine the correlations between HCY and other indicators;logistic regression model was used to analyze the risk factors of diabetic macroangiopathy and its subclasses;ROC curve was used to analyze the diagnostic value of HCY and uric acid in diabetic macroangiopathy.Results HCY in diabetic with macroangiopathy group was significant hiher than that in diabetic without macroangiopathy group 10.40(8.50-12.48) μmol/L 9.10(7.50-10.70) μmol/L, P<0.01).The incidence of diabetic macroangiopathy (χ2=7.030, P=0.030) and carotid artery lesions (χ2=7.258, P=0.027) was different in patients with different HCY levels.The correlation coefficients of HCY with urea nitrogen, creatinine, uric acid, urinary albumin/creatinine and estimated glomerular filtration rate (eGFR) were 0.340, 0.248, 0.278, 0.133,-0.369 (P<0.05), respectively.HCY was a risk factor for diabetic macroangiopathy, carotid plaque and cardiovascular disease;HCY, age and uric acid were independent risk factors for some of the diabetic macroangiopathy (P<0.05);HCY and UA had a certain diagnostic value for diabetic macroangiopathy(P<0.05).Conclusions Serum HCY is a risk factor for diabetic macroangiopathy, and detection of HCY levels will contribute to the diagnosis and prevention of the disease.