对氧磷酸酯酶-1活性在2型糖尿病及血管病变中的改变

Study on the relationship between paraoxonase-1 and vascular complications in patients with type 2 DM

目的:探讨PON-1活性在2型糖尿病(DM)中的改变及其在DM血管病变发生中的作用。方法:检测100例2型DM患者及40例正常对照的对氧磷酸酯酶-1(PON1)活性、总抗氧化能力(T-AOS)、氧化低密度脂蛋白(OX-LDL)、丙二醛(MDA)浓度变化,并按不同分组进行比较。血清PON-1活性用苯乙酸酯为底物,分光光度法测定,OX-LDL用ELISA法测定,MDA用硫带巴比妥酸法测定,T-AOS检测用分光光度法。结果:2型DM组PON-1活性比正常对照组显著降低(P<0.001),且与HDL减少无关,OX-LDL、MDA显著高于正常对照组(P<0.001,P<0.001),T-AOS显著低于正常对照(P<0.001)。合并血管病变的各组2型DM患者PON-1活性、T-AOS均低于无血管病变组,OX-LDL、MDA均高于无血管病变组。相关分析显示PON-1活性与T-AOS正相关(r=0.778,P<0.01),与OX-LDL(r=-0.643,P<0.01)呈负相关。PON-1活性影响因素经多元线性逐步回归分析,发现只有T-AOS、CHO、LDL、OX-LDL的回归系数P值<0.05。结论:2型DM患者PON-1活性下降,脂蛋白氧化易感性增加,血管易于损伤。PON-1活性降低是2型糖尿病大、微血管病变的危险因素。

Objective：To investigate the relationship between serum paraoxonase（ PON-1） activity and vascular complications including microanginopathy and macroanginopathy in patients with type 2 diabetes mellitus （DM）. Methods：Among one hundred patients with type 2 DM and forty normal controls, serum paraoxonase activity was assayed using phenyl acetate as a substrate;plasma oxidized low density lipoprotein （OX-LDL） was determined by ELISA; serum malondialdehyde （MDA） content and total antioxidant status（T-AOS） were also measured. Results：Serum PON1 activity was significantly lower in type 2 DM patients than that in controls（P〈0.001）. Among patients with type 2 DM, PON1 activity was significantly decreased in subjects with microanginopathy, compared with those without complications. PON1 activity was positively correlated with T-AOS, negatively correlated with OX-LDL,age,duration, MDA, CHO, LDL. Conclusions：Decreased PON-1 activity is an independent risk factor of type 2 DM patients with vascular complications.