Correlation of serum homocysteine, vitamin B12 and folic acid with oxidative stress in patients with diabetic retinopathy / 眼科新进展

ABSTRACT

Objective To analyze changes in serum homocysteine (Hcy),vitamin B12 (VitB12) and folic acid as well as the association with oxidative stress in patients with diabetic retinopathy (DR).Methods Totally 140 patients with type 2 diabetes (T2DM) in our hospital were selected,and underwent fundoscopy,fundus fluorescein angiography,and photograph examination.And according to the diagnosis from Chinese Medical Association Fundus Disease Group,the subjects were divided into 75 patients with non-diabetic retinopathy (NDR group),37 patients with nonproliferative diabetic retinopathy (NPDR group),and 28 patients with proliferative diabetic retinopathy (PDR group).Additional 70 patients,no blood sugar and abnormal hemoglobin,who received physical examination in our hospital were collected as normal control group.Then the levels of serum homocysteine (Hcy),vitamin B 12 (VitB 12),folic acid,superoxide dismutase (SOD),malondialdehyde (MDA),and reduced glutathione (GSH)were detected in each group.Then,the patients in the NPDR group was randomly divided into group A (18 patients) and group B (19 patients),and the former group was given orally with pancreatic kininogenase,and group B received VitB12 plus folic acid plus pancreatic kininogenase.After one month of treatment,the serum levels of Hcy,VitB12,fohc acid,SOD,MDA,and GSH were measured in the two groups.Results There were significant differences in the serum Hcy and MDA levels between the four groups (all P =0.000).The levels of both Hcy and MDA in the NDR group,NPDR group,and PDR group increased in turn and were significantly higher than those in the normal control group (all P ＜0.05).There were statistically significant differences in the serum VitB12,folic acid,SOD,and GSH levels among the four groups (all P =0.000).The levels of VitB12,folic acid,SOD,and GSH in the NDR group,NPDR group,PDR group decreased in turn and were significantly lower than those in the normal control group (all P ＜ 0.05).After one month of treatment,the levels of serum Hcy,MDA,VitB12,folic acid,SOD,and GSH in group A did not significantly changed when compared with before treatment (all P ＞=0.05);the serum Hcy and MDA levels in group B were significantly lower than before treatment (all P ＜ 0.05),serum VitB12,folic acid,SOD,GSH levels were significantly higher than before treatment (all P ＜ 0.05),and serum levels of Hcy and MDA in group B after treatment were significantly lower than those in group A (all P ＜ 0.05),VitB12,folic acid,SOD,and GSH levels were significantly higher than those in group A (all P ＜ 0.05).There was a positive correlation between serum Hcy and MDA level (r =0.79,P ＜ 0.05) and negative correlation with VitB12,folic acid,SOD,and GSH levels (r =-0.61,-0.54,-0.43,-0.57,all P ＜ 0.05).Conclusion Serum VitB12 and folic acid levels decreased,accompanied by increased Hcy level,and enhanced oxidative stress.Combination therapy with VitB12 and folic acid can decrease serum Hcy levels and alleviate oxidative stress responses in patients with DR.