Objective To investigate the effect of sitagliptin in the treatment of elderly patients with type 2 diabetes mellitus complicated with coronary heart disease and its influence on Hcy,irisin and chemerin.Methods From January 2015 to June 2016,600 elderly patients with type 2 diabetes mellitus complicated with coronary heart disease in the Sixth People's Hospital of Cixi were selected and divided into observation group and control group,with 300 cases in each group.The control group received metformin treatment,the observation group was given sitagliptin combined with metformin.Before and after treatment,the blood FBG,HbA1c and BMI,Hcy,irisin and chemerin levels were detected.Results After treatment,the FBG,HbA1 c and BMI levels in the observation group were significantly lower than those in the control group [(6.28 ± 1.43) mmol/L vs.(7.03 ± 1.04) mmol/L,t =5.256;(6.17 ± 1.02) ％ vs.(7.02 ± 0.98) ％,t =7.446;(21.03 ± 2.04) kg/m2 vs.(23.02 ± 1.23) kg/m2,t =14.469] (all P ＜ 0.05).The level of Hcy in the observation group after treatment was significantly lower than that in the control group [(7.48 ± 1.03) μmol/L vs.(10.38 ± 1.74) μmol/L,t =17.868,P ＜ 0.05].After treatment,the blood irisin level in the observation group was significantly higher than that in the control group [(3.28 ± 0.89) μg/mL vs.(2.43 ± 0.38)μg/mL,t =15.213,P ＜ 0.05].After treatment,the chemerin level in the observation group was significantly lower than that in the control group [(210.38 ± 9.84)ng/mL vs.(231.38 ± 10.03)ng/mL,t =24.379,P ＜ 0.05].Conclusion Sitagliptin in the treatment of elderly patients with type 2 diabetes mellitus complicated with coronary heart disease can effectively regulate the levels of Hcy,irisin and chemerin,and improve the curative effect.

Objective To investigate the correlation between cardiac function and homocysteine (Hcy) level in type 2 diabetes mellitus (T2DM) patients.Methods From May 2015 to April 2016,120 patients with T2DM in the Sixth People＇s Hospital of Cixi were selected.According to the level of Hcy,the patients were divided into DM group (Hcy level ＜15μmol/L,42 cases) and Hcy+DM group (Hcy level≥15 μmol/L,78 cases).And 50 healthy people were selected as control group.The correlations between various physiological and cardiac functional parameters and Hcy level among the three groups were analyzed.Results The levels of Hcy,HbA1c and FBG in the DM group were significantly higher than those in the control group [Hcy:(11.26 ±2.16)μmol/L vs.(8.24 ±1.25)μmol/L,HbA1c:(7.46 ±1.47)%vs.(5.02 ±1.73)%,FBG:(7.87 ±2.75) mmol/L vs.(5.78 ±2.83)mmol/L,all P＜0.05].The E/A value and LVEF value in the DM group were significantly lower than those in the control group (all P＜0.05).The Hcy,HbA1c,and FBG levels in the Hcy +DM group were significantly higher than those in the DM group,and the E/A value and LVEF value in the Hcy +DM group were significantly lower than those in the DM group (all P ＜0.05 ).Spearman＇s correlation coefficient analysis showed that there was a positive correlation between HbA1c and FBG levels and Hcy levels (r＝0.157,0.112,all P＜0.05),but there was a negative correlation between E/A and LVEF values and Hcy levels (r＝-0.264,-0.394,all P＜0.05).Logistic regression analysis showed that the independent risk factor affecting the E/A and LVEF values was Hcy levels ( P ＝0.015,0.001 ). Conclusion The level of Hcy in patients with diabetes can reflect the status of heart function.The higher the level of Hcy,the worse the heart function.The detection of Hcy level can help to predict and evaluate cardiac function in patients.