摘要
目的探讨糖耐量正常的2型糖尿病(T2DM)一级亲属(FDRs)循环内皮祖细胞(EPCs)水平与氧化应激及血管内皮功能变化及彼此之间的关系。方法选择T2DM患者40例,FDRs38例,正常对照组30例,测定EPCs数量、血管内皮依赖性舒张功能(FMD)、空腹血糖(FPG)、糖化血红蛋白(HbAlc)、TG、TC、丙二醛(MDA)、谷胱甘肽过氧化物酶(GSH-Px)、超氧化物歧化酶(SOD)及总抗氧化能力(TAO-C)、空腹胰岛素(Fins),稳态模型评估法计算胰岛素抵抗指数(HOMA-IR)。结果T2DM组FPG[(7.86±0.77)mmol/L]和HbAlc[(5.34±0.37)%]显著高于对照组[(4.90±0.35)mmol/L,(5.34±0.37)%]及FDRs组[(5.13±0.95)mmol/L,(5.36±0.36)%],P值均〈0.05。T2DM组的TC水平[(5.88±0.76)mmol/L]高于FDRs组[(4.95±0.76)mmol/L]和正常对照组[(4.66±0.90)mmo]/L],P〈0.05;HOMA-IR在对照组、FDRs组、T2DM组分别为0.48±0.25、0.81±0.46、1.47±0.24(P〈0.01);T2DM组的血清SOD、TAO-C及GSH-Px水平[(69.30±2.21)、(7.30±0.29)、(856.5±9.01)U/m1]显著低于对照组[(75.33±3.63)、(8.17±0.58)、(938.1±19.35)U/m1]及FDRs组[(74.91±4.53)、(8.24±0.46)、(936.9±15.78)U/m1],P值均〈0.01;血清MDA水平对照组为(2.87±0.63)txmol/L,FDRs组为(3.28±0.71)μmol/L,T2DM组为(3.69±0.39)μmol/L,P〈0.01;对照组的EPCs、反应性充血后肱动脉内径变化(FMD%)分别为96.75±8.11、8.36士2.21,高于FDRs组(83.34±12.43,6.78±0.98)和T'2DM组(58.45±7.58,2.864-0.35),P值均〈0.05。在FDRs组,HOMA-IR自然对数值与MDA呈正相关(r=0.486,P〈0.05),分别与SOD、TAO-C、GSH.Px呈负相关(r值分别为-0.426、-0.601、-0.524,P值均〈0.05)。结论在糖耐量正常的FDRs已经出现了胰岛素抵抗、氧化应激、EPCs数量的减少及FMD受损,且四者之间存在相关性。
Objective To study the relationship between oxidative stress and endothelial progenitor cells (EPCs) count in the first-degree relatives of diabetes mellitus(FDRs). Methods Three groups were evaluated with 40 type 2 diabetes mellitus (T2DM) patients, 38 FDRs and 30 healthy individuals as the control (NC). Fasting plasma glucose (FPG), glycosylated hemoglobin (HbAlc), TG, TC and fasting plasma insulin concentrations were measured and homeostasis modal assessment-insulin resistance (HOMA- IR) was calculated. Quantity of EPCs and flow-mediated dilation (FMD) were evaluated. Malonaldehyde ( MDA), glutathion peroxidase ( GSH-Px), erythrocuprein(SOD) and total anti-oxidative capacity (TAO-C) were measured. Results In T2DM group FPG[ (7. 86±0. 77 )mmol/L] and HbAle[ (7.24±0. 20) % ] were significantly higher than those in NC [ FPG ( 4. 90 ± O. 35 ) mmol/L, HbA1 c ( 5.34 ± 0. 37 ) % ] and FDRsgroup[FPG (5.13±0.95) mmol/L, HbAlc(5.36±0.36)%] (all P values 〈0.05). TC in T2DM group [(5.88 ±0.76) mmol/L] was higher than in NC[(4.66 ±0.90) mmol/L] and FDRs [ (4. 95 ±0. 76)mmol/L]. HOMA-IR was 0. 48 ±0. 25 in NC, 0. 81 ±0. 46 in FDRs and 1.47 ±0. 24 inT2DM group, P 〈 0. 01. In T2DM group, the plasma levels of SOD [ (69.30 ± 2. 21 ) U/m1], TAO-C [ (7.30 + 0. 29) U/ml] and GSH-Px [ (856.5 ± 9.01 ) U/ml were significantly lower than those in NC [ SOD (75.33 ± 3.63 ) U/ml, TAO-C (8. 17± O. 58 ) U/ml and GSH-Px (938. 1±19. 35 ) U/ml ] and FDRs group[SOD (74. 91±4. 53) U/ml,TAO-C (8.24 +0. 46) U/ml and GSH-Px(936. 9± 15.78) U/roll (all P values 〈 0.01 ). Serum level of MDA was (2. 87± 0. 63 ) μmol/L in NC, ( 3.28± 0. 71 ) μmol/L in FDRs and(3.69 ±0. 39 ) μmol/L in T2DM group ( P 〈 0. O1 ). The quantity of EPCs and FMD% were 96.75+8. 11 and 8.36 ±2.21 in NC, 83.34±12.43 and 6.78 ±0.98 in FDRs and 58.45 +7.58 and 2. 86 ± 0. 35 in T2DM group with statistical differences between different groups ( all P values 〈 0. 05 ). Pearson correlation analysis showed that InHOMA-IR was positively correlated with MDA ( r = 0. 486, P 〈 0. 05)and negatively correlated with SOD, TAO-C, GSH-Px( r = -0. 426, -0. 601, -0. 524, all P values 〈 0. 05 ) in FDRs group. Conclusions Insulin resistance, oxidative stress, decreased quantity of EPCs and impairment of endovascular function have already occurred in the FDRs of T2DM with normal glucose tolerance and they are correlated with each other.
出处
《中华内科杂志》
CAS
CSCD
北大核心
2012年第3期197-200,共4页
Chinese Journal of Internal Medicine
基金
河北省科技支撑计划项目
关键词
糖尿病
2型
内皮
血管
内皮祖细胞
一级亲属
氧化应激
Diabetes mellitus,type 2
Endothelium, vascular
Endothelial progenitor cells
First degree relatives
Oxidative stress