| Objectives To study the related factors of plasma homocysteine level in patients with type 2 diabetes mellitus. To analyse the risk factor of hyperhomocysteinemia in patients with type 2 diabetes mellitus.To observe the impact of folic acid,vitamin B12,riboflavin on the plama homocysteine levels of patients with type 2 diabetes mellitus.Methods1.The related factors of Hcy 180 patients with type 2 diabetes mellitus were selected as subjects, in which 84 cases were male and 96 cases were female, aged 25-75 years old. Face to face questionnaire and retrospective investigation were used to collect the general situation, diabetes morbidity, concurrent disease and so on. Select non-diabetic people whose age, sex, body mass index (BMI) are resemblance with the subjects, as control group, a total of 30 cases. To collect the general condition and other information of the normal control group in the same way.Early morning fasting blood 8ml were collected from patients with type 2 diabetes mellitus and control to analyse the level of plasma homocysteine, serum folate, VB12, VB2, fasting blood glucose & blood lipid level and renal function in the two groups. Explore the difference between determination of indicators for patients with type 2 diabetes mellitus and normal control group.All patients with type 2 diabetes mellitus were divided into combined macrovascular disease group and non-merger macroangiopathy group. Analyse Hcy, FA, VB12, VB2, fasting blood glucose, blood lipid levels and renal function in the two groups. View the relationship between Hcy and other indicators and combined macrovascular disease in patients with type2 diabetes mellitus.Pearsan analysis is used in analyzing the correlation of Hcy with FA, VB12, VB2 and other indicators in patients with type 2 diabetes mellitus, to identify the relevant factor of Hcy.As to the type 2 diabetes mellitus with hyperhomocysteinaeia, approach the relevant factors of type 2 diabetes mellitus with hyperhomocysteinaeia, unconditioned Logisitic stepwise regression analysis was used in analyzing hierarchical general information, such as sex,age,BMI and clinical indicators, FA,VB12,VB2, fasting blood glucose for instance. Screen the relevant factors of HHcy in patients with type 2 diabetes mellitus.2 The impact of FA,VB12,VB2 on the levels of Hcy in patients with type2 diabetes mellitusPatients with type 2 diabetes mellitus were completely randomized into five groups according to admission. Different intervention means were used.Group A: FA 5mg/d; Group B: VB12 0.5mg/d; Group C: VB2 5mg/d; Group D: FA 5mg/d and VB12 0.5mg/d; Group E: no vitamin intervention.Detect Hcy,FA,VB12,VB2 prior/post intervention in each group. Compare the variation of Hcy, FA, VB12,VB2 in prior/post intervention. Evaluate the effect of intervening factors to the Hcy in patients with type 2 diabetes mellitus.Results1 Comparing T2DM with normal control group, plasma homocysteine levels were significantly higher than the normal control group. There was marked change inVB12,VB2,HDL,LDL,APOA,APOB,FPG,SBP, DBP and BUN.The difference was statistically significant(P<0.05). The prevalence rate of HHcy in T2DM was 83.89%,and 10.00% in control group.2 Comparing T2DM who have got macroangiopathy with T2DM who haven't got macroangiopathy,the difference in age,duration,BMI,FA, VB12,VB2,CHOL,TG,SBP,DBP,UA,BUN and CREA was statistically sig- -nificant(P<0.05).Plasma homocysteine levels were significantly higher than non-complication group(P<0.01). The prevalence rate of HHcy in T2DM with macroangiopathy was 98.97%,66.26% in T2DM without macroangiopathy.3 In order to analyse the related factors of Hcy in patients with type 2 diabetes mellitus,Pearsan correlation analysis was used in Hcy,age,durati- -on,BMI,FA,VB12,VB2,CHOL,TG,HDL,LDL,APOA,APOB,FPG,SBP,DBP,UA,BUN and CREA.The result showed duration,FA,BGRAC,APOA and CERA was inverse correlation with Hcy,and have statistical significance(P<0.05).4 In order to analyze the risk factors of hyperhomocysteinemia in T2DM, unconditioned Logistic stepwise regression analysis was used,it showed that LDL and duration were risk factors of hyperhomocysteinemia( was greater than zero).VB12,VB2 and HDL were protective factors( was less than zero).At the same time as the determination of VB2 indicator is BGRAC, the higher the coefficient,and the lower the level VB2 was. So VB2 was also protective factor.5 Differet intervention factor has defferent influence:FA intervention group,VB12 intervention group,VB2 intervention group and FA combined with VB12 intervention group can decrease the level of Hcy in patients with type 2 diabetes mellitus. FA intervention group and VB12 intervention group have obvious effect than VB2 intervention group and FA combined with VB12 intervention group,and the influence was significantly different. From this and the factorial design analysis of variance results suggested that there was antagonistic action with FA acid and VB12. Conclusions1 Comparing with the control group,the level of Hcy in T2DM was high.In T2DM group,comparing with whether accompanying with macroangi- -opathy,the level of Hcy was high in T2DM with macroangiopathy.2 It is found that duration,FA,VB2,APOA and CREA was correlated with Hcy. Duration and CREA was positively correlated with Hcy.FA, VB2 and APOA was negatively correlated with Hcy.3 As analysis of the risk factor in T2DM with heperhomocysteinemia,it is found that VB12,VB2 and HDL have protective effect,but duration and LDL have damaging effect.4 FA intervention group,VB12 intervention group,VB2 intervention group and FA combined with VB12 intervention group can all decrease the level of Hcy in patients with type 2 diabetes mellitus.At the same time,FA intervention group and VB12 intervention group have obvious effect than VB2 intervention group and FA combined with VB12 intervention group.
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