糖尿病及其视网膜病变患者抗氧化酶及氧化应激产物的变化

Change of antioxidative enzymes and products of oxidative stress in diabetes mellitus and diabetic retinopathy

目的观察糖尿病视网膜病变(diabetic retinopathy,DR)患者氧化应激状态和血清中氧化应激代谢产物的变化及其与糖尿病合并视网膜损伤之间的关系。方法2型糖尿病患者51例,分为无糖尿病并发症(diabetes mellitus,DM)组(n=24),糖尿病合并视网膜病变(DR)组(n=27),另选同期体检健康者为对照组(n=30)。收集空腹血清,测定超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)、过氧化氢酶(CAT)活力;氧化应激代谢产物丙二醛(MDA)、共轭二烯及晚期蛋白质氧化产物(AOPP)的含量。结果与正常对照组比较,DM及DR患者血清中抗氧化酶SOD、GSH-Px、CAT活力均显著下降(P<0.01,P<0.05),而且DR患者SOD活力又明显低于DM患者(P<0.05);血清中蛋白质氧化应激产物AOPP、脂质过氧化产物MDA及共轭二烯均明显升高(P<0.01,P<0.05),DR患者MDA和共轭二烯含量比DM患者升高更为明显(P<0.05)。结论糖尿病及其视网膜病变患者存在着严重的氧化应激,控制机体的自由基平衡可能有利于糖尿病及其并发症的治疗与控制。

Objective To observe the status of oxidative stress and determine the products of oxidative stress in type 2 diabetes mellitus with or without retinopathy and to investigate the relationship between oxidative stress and type 2 diabetic retinopathy patients. Methods Fifty-one diabetes mellitus patients were divided into 2 groups as diabetes mellitus group （DM） and diabetic retinopathy group （DR）, 30 healthy subjects were included as control. Superoxide dismutase （SOD） , glutathione peroxidase （ GSH- Px）, catalase （ CAT）, malondialdehyde （MDA）, conjugated diene （ CD）, and advanced oxidation protein products （AOPP） were measured, respectively. Results Compared with control group, the levels of SOD, GSH-Px, CAT in serum in DM and DR were lower （ P 〈 0.05 ）. Moreover, SOD levels in diabetes mellitus retinopathy patients were significantly lower compared with that in diabetic patients without complications （P 〈 0. 05 ）. The serum concentrations of MDA, CD, and AOPP in DM patients and in DR patients were significantly higher than those in the control subjects （P 〈 0.05, P 〈 0.01 ）. The concentrations of MDA and CD in patients with retinopathy were significantly elevated compared to diabetic patients without complications （P 〈 0.05, P 〈 0.01 ）. Conclusion Diabetes mellitus patients, especially DR patients have severe oxidative stress. Controlling the balance of free radicals will probably be helpful for diabetes mellitus patients.