Correlation Between Serum Folic Acid,VitB12 And Plasma Homocysteine Concentrations And Secondary Peripheral Neuropathy Of Newly Diagnosed Diabetes

Objective:To explore the relationship between serum folic acid,VitB12 and plasma homocysteine concentrations and Diabetic Peripheral Neuropathy,therefore,The concentrations of serum folic acid,Vitamin B12 and plasma homocysteine in Diabetic Peripheral Neuropathy group,non-Diabetic Peripheral Neuropathy group and healthy group are determined.The research provides reliable theoretical basis for early prediction diagnosis and effective prevention and treatment of Diabetic Peripheral Neuropathy.Methods:In this study,a total of 112 adult subjects(67 males and 45 females)who was initially diagnosed as diabetes in the First People’s Hospital of Changzhou from September,2015 to September,2016 were randomly enrolled.By electromyography and neurological score(NSS),58 subjects(34 males and 24 females)without Diabetic Peripheral Neuropathy and clinical manifestations were chosen in the non-Diabetic Peripheral Neuropathy,while the other 54 patients(33 males and 21 females)were chosen in the Diabetic Peripheral Neuropathy group.And at the same time,40 healthy adult subjects(8 males and 32 females)who had a medical examination in the First People’s Hospital of Changzhou from September,2015 to September,2016 were chosen in the healthy group.The elbow vein blood of every subject was collected in the fasting state to determine serum folic acid,VitB12 and plasma homocysteine concentrations.And then,using t-test,the difference of the concentrations among Diabetic Peripheral Neuropathy group,non-Diabetic Peripheral Neuropathy group and healthy group was compared.Chi-square test was used to analyze the correlation between the variables.Person correlation analysis and logistic stepwise regression analysis were used to study the correlation index of homocysteine level.Results:1.There was no statistical difference in age,smoking duration,body mass index,creatinine,systolie blood pressure and diastolic blood pressure among the healthy group,non-DPN group and DPN group(P>0.05).In course of disease,there was statistical difference between non-DPN group and the other two groups(P<0.01,P<0.01).In the levels of fibrinogen,glycosylated hemoglobin,triglycerides and fasting plasma glucose,there was statistical difference between non-DPN group and the healthy group(P<0.01),while there was no statistical difference between the DPN group and the non-DPN group.And in the levels of total cholesterol and high density-lipoprotein,there was statistical difference between non-DPN group and the healthy group(P<0.05)and no statistical difference between the DPN group and the non-DPN group.At the same time,in the levels of low density-lipoprotein,there was statistical difference between non-DPN group and the other two groups(P<0.05,P<0.05)2.The serum folic acid concentrations of healthy group,non-DPN group and DPN group were separately(18.30±11.40)nmol/L,(12.50±7.60)nmol/L and(9.50±4.50)nmol/L.And there was statistical difference between the non-DPN group and the healthy group(P<0.01),as well as between the non-DPN group and DPN group(P<0.05).The serum VitB12 concentrations of healthy group,non-DPN group and DPN group were separately(345.90±26.90)pmol/L,(257.60±22.60)pmol/L and(216.10±19.20)pmol/L.And there was statistical difference between the DPN group and the healthy group(P<0.05),while no statistical difference was figured out between the DPN group and the non-DPN group.The plasma homocysteine concentrations of healthy group,non-DPN group and DPN group were separately(7.99±2.84)μmol/L,(13.67±2.75)μmol/L and(18.53±4.03)μmol/L.And there was statistical difference between non-DPN group and the other two groups(P<0.01).The homocysteinemia incidence of healthy group,non-DPN group and DPN group were separately 7.50%,24.14% and 59.26%.And there was statistical difference between the non-DPN group and the healthy group(P<0.01),as well as between the non-DPN group and DPN group(P<0.05).3.Logistic Multiple factors analysis showed that severity of DPN correlated with plasma homocysteine concentration(OR=6.883),course of disease(OR=3.921),and High density-lipoprotein level(OR=7.260).4.It was shown in the Person correlation analysis that the plasma homocysteine concentration positively correlated with course of disease(r=0.882,p=0.010),glycosylated hemoglobin level(r=0.235,p=0.010)and creatinine level(r=0.575,p=0.025),and negatively correlated with apolipoprotein A level(r=-0.213,p=0.017)and serum folic acid concentration(r=-0.362,p=0.007).The plasma homocysteine concentration negatively correlated with serum VitB12 concentration(r=-0.004,p=0.078)and high density lipoprotein level(r=-0.100,p=0.471),but the correlation showed no statistical difference(P>0.05).5.It was shown in the Logistic regression analysis that serum folic acid concentration,serum VitB12 concentrations and high-density lipoprotein cholesterol(HDL-c)level could be used as the protection factors of DPN(β was negative).With the increase of serum folic acid concentration,serum VitB12 concentrations and high-density lipoprotein cholesterol(HDL-c)level,the plasma homocysteine concentrations of subjects who was diagnosed as diabetes decreased.The major risk factors for diabetes patients with DPN were course of disease and low density lipoprotein level.If the course of disease extended or the low-density lipoprotein level increased,the diabetes Hcy levels would increase causing certain dangers.Conclusion:1.Plasma Hcy concentrations can be used as a risk factor and predictor for DPN.2.Diabetic patients without DPN should monitor plasma Hcy concentrations.If there is a homocysteine anemia or plasma Hcy concentrations constantly increase,regular supplements of folic acid and VitB12 are needed.3.Low serum folic acid and VitB12 concentrations are inducing factors for high levels of homocysteine.So,by increasing serum folic acid and VitB12 concentrations,It is possible to reduce the plasma homocysteine levels in diabetic patients to delay the occurrence and development of DPN.