Influence Of Smoking On Serum Homocysteine Of Patients Diagnosed With Impaired Glucose Regulation

ObjectiveTo probe into the connection between active smoking and concentration of serum homocysteine for patients already diagnosed with impaired glucose regulation,and its potential mechanism which brings about the close connection.MethodsThe investigation encompassed two hundred and thirty-six cases who were already diagnosed with IGR clearly by accepted oral glucose tolerance test(OGTT),86 cases of who smoking were defined as smoking group with IGR, and 150non-smokers as non-smoking group with IGR, another 70 cases denying the history of smoking whose fasting plasma glucose and OGTT2 h plasma glucose value were both no abnormal and age, sex ratio, BMI were all similar to patients diagnosed with IGR were chosen as the normal control group in this research. We respectively detected specific value of serum homocysteine, fasting insulin, blood glucose composition( FPG, OGTT2 h PG, glycosylated hemoglobin) and blood lipid composition(TC, HDL-C, LDL-C, TG)and fasting hepatorenal function in all of the participants. And to accurately calculate or measure their BMI, homeostasis model of assessment for insulin resistence(HOMA-IR), smoking index(a product of the number of cigarettes / day and years of smoking), SBP, DBP and other relevant parameters which were vital in three groups of subjects. Morever, related comparison of differences concerning above indexes between the groups was respectively conducted.Results1. The differences of age, sex ratio, BMI, creatinine, SBP and DBP between the three groups showed no significance(P>0.05).2. The calculated ln(HOMA-IR), FPG, glycosylated hemoglobin, TC, TG and Hcy concentration raised inch by inch in the control group, non-smoking group with IGR, smoking group with IGR, the great differences between these three groups were apparently significant. Compared with control group, the level of LDL-C wasobviously much higher in non-smoking group with IGR and smoking group with IGR(P<0.05). While the the level of HDL-C of in smoking group with IGR was lower than other two groups(P<0.05).3. When we adjusted for time of life, sex ratio, ln(HOMA-IR), baric index, TG,TC and other potential confounders together, smoking still played a major role in hyperhomocysteinemia [OR(95%CI) =2.103(1.017 ~ 4.348), P<0.05] in patients suffering form impaired glucose regulation. Furthermore the greater smoking index,the much higher value of serum Hcy may exist for patients suffering form impaired glucose regulation(F=7.391,P<0.05)。4. In 236 cases who suffered from IGR, It was worth mentioning that there existed a significant positive correlation between the value of ln(HOMA-IR) and serum Hcy(the coefficient of correlation r=0.296, P < 0.01), at the same time the positive correlation continued between the value of ln(HOMA-IR) and Hb A1C(r=0.163,P<0.05).Conclusions1. There exists a serious metabolic disturbance of Hcy not only in diabetics, but also in the sick population suffering form IGR.2. Smoking may be an independent and indispensable influence factor bringing about hyperhomocysteinemia for those suffering form IGR. Perhaps there is an indispensable dose-response connection between the amount of cigarette smoking and concentration of serum Hcy in those suffering form IGR.3. Within the sick population suffering form IGR, apparently there exists a positive correlation between the concentration of serum Hcy and insulin resistance,the positive correlation continued between Hb A1 C and insulin resistance.4. Smoking can worsen insulin resistance further for those people suffering form IGR, perhaps one of the most important mechanisms that smoking can lead to hyperhomocysteinemia for patients suffering form IGR results form worse insulin resistance caused by smoking.