2型糖尿病患者胰岛素抵抗和氧化应激反应

Study on insulin resistance and oxidative stress in T2DM patients

目的探讨机体的氧化应激和抗氧化防御在胰岛素抵抗诱导的2型糖尿病(T2DM)发生发展过程中的作用。方法通过口服糖耐量试验,将所有对象分成正常糖耐量(NGT)、葡萄糖不耐受(G1)和T2DM组。测定血浆丙二醛(MDA)含量,以评价机体氧化应激;测定血浆总抗氧化能力(TAOC)、红细胞谷胱甘肽(GSH)和超氧化物歧化酶(SOD)含量,评价机体的抗氧化防御,使用稳态模型评价机体的胰岛素抵抗及胰岛β-cell分泌功能。结果T2DM组的血浆丙二醛(MDA)浓度明显高于G1和NGT组(P<0.01,P<0.001);T2DM组血浆TAOC活性相对于G1组和NGT组显著下降(P=0.001,P<0.01)。3组间空腹胰岛素(FP1)和胰岛素抵抗数(HOMA IR)差异均有统计学意义(P<0.05)。胰岛素抵抗指数和体质指数(BMI)及血浆MDA呈显著正相关(P<0.001,P=0.003),和血浆TAOC、红细胞SOD呈显著负相关(P=0.017,P=0.014)。结论氧化应激在胰岛素抵抗介导的T2DM起始及发生发展过程中可能发挥重要作用。

Objective To explore the important roles of oxidative stress in the initiation and development of type 2 diabetes mellitus induced by insulin resistance. Methods By oral glucose tolerance test all enrolled subjects were divided into three groups： normal glucose tolerance （NGT）, glucose intolerance （G1）and new diagnosed type 2 diabetes mellitus （T2DM）. Plasma （MDA）was chosen to play a biomarker of oxidative stress, while plasma total antioxidation capability （TAOC）, erythrocyte superoxide （SOD）and erythrocyte reduced glutathione （GSH） were chosen to play biomarkers of an- tioxidant defense system. By detecting fasting insulin levels, the insulin resistance and β - cell function were estimated with homeostasis model assessment （HOMA）, Results The plasma MDA levels increased significantly in T2DM individuals versus G1 individuals and NGT individuals （P〈 0.001and P〈 0. 001 ）, The plasma TAOC levels decreased significantly in T2DM individuals versus G1 individuals and NGT individuals（ P 〈 0.001and P = 0,003 ）, The insulin resistance had significanrt difference among three groups. The index of insulin resistance（HOMA IR）was related positively to body mass index（BMI）and plasma MDA levels （P 〈0.001and P = 0. 003）, There was an adverse relationship between homeostasis model assessment insulin resistance （HOMA IR）and plasma TAOC or erythrocyte SOD activity （P = 0. 017 and P = 0.014）, Conclusion The risk factors of T2DM can induce insulin resistance by increasing the organism＇s oxidative stress, Oxidative stress may play key roles in the pathogenesis of type 2 diabetes mellitus,