糖尿病肾病患者晚期氧化蛋白产物与SOD、TNF-α的关系

Relationship between AOPP and SOD, TNF-α in Diabetic Nephropathy

目的研究糖尿病肾病患者血清蛋白氧化损伤指标晚期氧化蛋白产物(AOPP)的改变及其与超氧化物歧化酶(SOD)、肿瘤坏死因子α(TNF-α)的关系,探讨蛋白氧化损伤与糖尿病肾病氧化应激状态和炎症因子的关系。方法糖尿病患者85例,根据尿微量白蛋白排泄率和肌酐水平分为无肾病(DM)组、早期肾病(DN3)组、临床肾病(DN4)组、终末期肾病(DN5)组。用Witko-Sarsat介绍的方法改进后分别测定各组的血清AOPP,黄嘌呤氧化酶法测定SOD,ELISA方法测定血清TNF-α。结果DN5组患者的血清AOPP(117.8±64.8)μmol/L和DN4组的血清AOPP(80.0±23.0)μmol/L显著高于DM组(58.2±17.7)μmol/L(P<0.01);DN3组血清AOPP(72.7±17.2)μmol/L与DM组比较无统计学意义。血清AOPP与SOD显著负相关(r=-0.217,P<0.05),与TNF-α无明显相关性(r=-0.064,P<0.01)。结论临床糖尿病肾病患者的血清蛋白氧化较无糖尿病肾病患者增强,并且与糖尿病肾病氧化应激状态有关,但与炎症因子TNF-α无明显关系。

Objective to study the changes of AOPP（advanced oxidation protein products） in diabetic nephropathy（DN） patients, as well as its correlationship with superoxide dismutase（SOD）, tumor necrosis factor-α （TNF-α）. Methods according to concentration of urinary albumin excretion rate （UAER） and creatinine（Cr）, 85 diabetes mellitus（DM） patients were conducted into 4 groups as non-DN group（DM）, early-staged DN group（DN3）, significant DN group（DN4） and end-staged DN group（DN5）. The concentration of serum AOPP was measured by ameliorated method introduced by Wikto-Sarsat, while SOD by Xanthine oxidase test, TNF-a by EI.ISA assay. Results AOPP in group DN5 （117.8± 64.8 μmol/L） and group DN4 （80. 0±23. 0 μmol/L） were significantly higher than that in group DM （58.2±17. 7 μmol/L）, （P〈0.01）. There was no significant difference of AOPP between group DN3 （72.7± 17.2 μmol/L） and group DM（58. 2 ± 17. 7 μmol/L）. Serum AOPP negatively correlated with SOD（r=-0.21,P〈0.05）, but uncorrelated with TNF-α（r=-0.064,P〈0.01）. Conclusions DN patient has enhanced protein oxidation compared with DM patient without DN, which is related with oxidative stress but uncorrelated with TNF-α.