Using Three-dimensional Ultrasound Evaluate The Gallbladder Emptying Function Of Diabetes With High Level Homocysteine

Objective:To study the clinic application and value of using three dimensional imaging ultrasound to evaluate gallbladder emptying function in type 2 diabetes mellitus (T2DM). And talk about the relationship between the homocysteine (Hey) concentration in blood increased and gallbladder emptying dysfunction in type 2 diabetes mellitus (T2DM) preliminarily.Methods:Collect 23 cases of T2DM and 20 cases of normal people were considered as control group. According to the concentration of homocysteine in plasma, divided type 2 diabetes into 13 cases of T2DM with high concentration of homocysteine group (DM1 group) and 10 cases of T2DM with normal concentration of homocysteine group (DM2 group).Use three dimensional imaging ultrasound to acquire and save the images with maximum oblique diameter in fasting and postprandial gallbladder of each groups and times. Then use quantitative measuring QLAB software to calculate the three-dimensional volume of each groups and times. At last, point out the gallbladder ejection fraction in each groups and times. At the same time, draw fasting blood for the following tests, concentration of homocysteine, glycosylated hemoglobin, fasting insulin, fasting c-peptide and high-density lipoprotein cholesterol in blood. Using multiple stepwise regression to analysis which index has high the relevance with the gallbladder emptying.Results:The gallbladder emptying ejection fraction in DM1 group was obviously lower than normal group and DM2 group, differences were statistically significant (P< 0.01); There was no significant difference, when the group of DM2 was compared with normal control group. Compared with control group, the level of homocysteine, glycosylated hemoglobin, fasting glucose, fasting c-peptide in DM1 group and the concentration of glycosylated hemoglobin, fasting glucose, fasting c-peptide in DM2 group were elevated, high-density lipoprotein cholesterol (HDL-C) level in DM1 and DM2 group were reduced, the differences were significancant statistically (P< 0.05); DM1 group was compared with DM2 group, the level of homocysteine, glycosylated hemoglobin, fasting glucose, fasting c-peptide in DM1 group were higher than the level of those in DM2 group, moreover the concentration of HDL-C is lower than the level of it in DM2 group, the difference was statistically significant (P< 0.05).Use multiple linear stepwise regression analysis showed that indexes have strong correlation with gallbladder emptying ejection fraction were homocysteine, glycosylated hemoglobin, fasting plasma glucose in turn.Conclusion:1.Using the three-dimensional ultrasonic imaging technology to detect gallbladder emptying in patients with type 2 diabetes mellitus and high levels of homocysteine. The three-dimensional ultrasonic imaging technology has advantages of no invasion, no radiation dynamic observation, easily acception, convenience and accuracy; 2.Type 2 diabetes mellitus, especially with high levels of homocysteine, were susceptible to gallbladder emptying dysfunction, increased homocysteine in blood might be an important influence factor in gallbladder emptying disorder; 3.Using the three-dimensional ultrasonic imaging technology to detect the gallbladder emptying function in Type 2 diabetes mellitus, especially with high homocysteine in blood but no digestive discomfort symptoms, would provide imaging basements for clinical early discovery and improvement of gallbladder emptying function.