Age and kidney function are the primary correlates of fasting plasma total homocysteine levels in non-diabetic and diabetic adults. Results from the 1999-2002 National Health and Nutrition Examination Survey.
Age and kidney function are the primary correlates of fasting plasma total homocysteine levels in non-diabetic and diabetic adults. Results from the 1999-2002 National Health and Nutrition Examination Survey.
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DOI：
10.1186/1743-7075-2-13
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发表时间：
2005-05-26
影响因子：
4.5
通讯作者：
Zhou, Xiao-Hua
中科院分区：
文献类型：
--
作者：
Duncan, Glen E;Li, Sierra M;Zhou, Xiao-Hua
背景：血浆总同型半胱氨酸（tHcy）通常在糖尿病患者中升高。这可能是由于胰岛素和/或葡萄糖和/或代谢控制对tHcy代谢或血浆水平的影响。本研究探讨了空腹血浆葡萄糖状态对无糖尿病的成年人空腹tHcy水平的影响，以及有糖尿病自我报告病史的成年人糖尿病本身的影响。方法：对禁食至少8小时的成年人（≥ 20岁）的数据进行分析，这些数据来自国家健康和营养检查调查（1999-2000年和2001-2002年）。无糖尿病病史的受试者根据空腹血糖状态分为正常（< 100 mg/dL = NFG，n = 2，244）、受损（>或= 100 < 126 mg/dL = IFG，n = 1，108）或临时诊断为糖尿病（>或= 126 mg/dL = DFG，n = 133）。结果：与NFG相比，DFG和IFG的非糖尿病受试者的空腹tHcy更高（Ps < 0.01）（中位数[95%置信区间]分别为8.6 [8.0-9.2]，8.3 [8.1-8.5]和7.4 [7.3-7.5] μ mol/L）。糖尿病受试者的DFG和IFG水平与非糖尿病受试者相似（8.3 [7.9-8.6] μ mol/L）。在非糖尿病受试者中，年龄和估计肌酐清除率与空腹tHcy密切相关（r分别为0.38 ~ 0.44和r = -0.35 ~-0.46）和糖尿病受试者（r = 0.41和r =-0.46）空腹血糖和糖化血红蛋白（HbA 1c）与非糖尿病和糖尿病患者的tHcy相关性较弱（但仍有显著性）。结论：空腹血糖水平升高的非糖尿病成人患者的tHcy水平高于空腹血糖水平正常者和糖尿病成人患者。然而，空腹tHcy升高似乎主要由年龄和肾功能介导，而不是通过葡萄糖代谢的措施。
BACKGROUND: Plasma total homocysteine (tHcy) is commonly elevated in persons with diabetes. This may be due to effects of insulin and/or glucose and/or metabolic control on the metabolism or plasma levels of tHcy. This study examined the effects of fasting plasma glucose status on fasting tHcy levels among adults without diabetes, and diabetes per se among adults with a self-report history of diabetes.METHODS: Analysis of data on adults (> or = 20y) who had fasted at least 8 hours, from the National Health and Nutrition Examination Survey (1999-2000 and 2001-2002). Subjects with no self-report history of diabetes were grouped according to fasting plasma glucose status as normal (< 100 mg/dL = NFG, n = 2,244), impaired (> or = 100 < 126 mg/dL = IFG, n = 1,108), or a provisional diagnosis of diabetes (> or = 126 mg/dL = DFG, n = 133). Subjects with a self-report history of diabetes (n = 275) were examined separately.RESULTS: Fasting tHcy was higher (Ps < 0.01) among non-diabetic subjects with DFG and IFG, compared to NFG (median [95% confidence interval] = 8.6 [8.0-9.2], 8.3 [8.1-8.5], and 7.4 [7.3-7.5] micromol/L, respectively). Diabetic subjects had levels similar to non-diabetic subjects with DFG and IFG (8.3 [7.9-8.6] micromol/L). Age and estimated creatinine clearance were strong correlates of fasting tHcy among non-diabetic subjects (r = 0.38 to 0.44 and r = -0.35 to -0.46, respectively) and diabetic subjects (r = 0.41 and r = -0.46, respectively) (Ps < 0.001), while fasting glucose and glycohemoglobin (HbA1c) were weaker (but still significant) correlates of tHcy in non-diabetic and diabetic subjects. Fasting glucose status was not a significant independent predictor of fasting tHcy levels in non-diabetic subjects, and HbA1c was not a significant independent predictor of tHcy in diabetic subjects (Ps > 0.05).CONCLUSION: Fasting tHcy levels are elevated among non-diabetic adults with elevated fasting glucose levels, compared to persons with normal fasting glucose levels, and among diabetic adults. However, elevations in fasting tHcy appear to be mediated primarily by age and kidney function, and not by measures of glucose metabolism.