谷胱甘肽系统对2型糖尿病患者冠状动脉病变程度的影响

Effect of glutathione system on coronary artery lesion in type 2diabetes mellitus patients

目的探讨谷胱甘肽系统对2型糖尿病(T2DM)患者冠状动脉病变程度的影响。方法选取行冠状动脉造影术的患者236例,分为正常糖耐量(NGT)组126例,T2DM组110例,检测患者的血液生化指标以及还原型谷胱甘肽(GSH)、GSH过氧化物酶(GSH-Px)和谷胱甘肽还原酶(GR)的活性。根据冠状动脉造影结果,采用Gensini评分系统对每支血管病变程度进行定量评分。结果 T2DM组血浆GSH[(3.87±1.55)μg/L vs(4.45±1.94)μg/L]、GSH-Px[(0.29±0.05)ng/L vs(0.35±0.08)ng/L]和GR[(0.19±0.07)ng/L vs(0.26±0.08)ng/L]活性明显低于NGT组,差异有统计学意义(P<0.05)。校正年龄、体重指数、血压、血脂、空腹血糖、空腹胰岛素、餐后2h血糖、餐后2h胰岛素、糖化血红蛋白因素后,T2DM组GSH、GSH-Px、GR活性与Gensini积分呈负相关(P<0.05,P<0.01)。T2DM组GSH、GSH-Px和GR活性对Gensini积分的影响作用最大。结论 T2DM患者血浆GSH、GR和GSH-Px活性的降低与冠状动脉病变程度具有一定的负相关性,且为该人群冠状动脉病变的独立影响因素。

Objective To study the effect of glutathione（GSH）system on coronary artery lesion in type 2diabetes mellitus（T2DM）patients.Methods Two hundred and thirty-six patients who underwent coronary angiography were divided into normal glucose tolerance（NGT）group（n=126）and T2 DM group（n=110）.Their biochemical indexes were assayed and serum levels of GSH,GSH-Px and GR were meausred.Their coronary artery lesion was scored according to the Gensini scoring system.Results The serum levels of GSH,GSH-Px and GR were significantly lower in T2 DM group than in NGT group（3.87±1.55μg/L vs 4.45±1.94μg/L,0.29±0.05ng/L vs0.35±0.08ng/L,0.19±0.07ng/L vs 0.26±0.08ng/L,P〈0.05）and negatively related with the Gensini score after adjustment for age,BMI,blood pressure,blood lipids,fasting glucose and insulin,postprandial 2hglucose and insulin,HbA1c（P〈0.05,P〈0.01）,indicating that the serum levels of GSH,GSH-Px and GR could significantly influence the Gensini scores in T2 DM patients.Conclusion Low serum levels of GSH,GSH-PX and GR are negatively related with coronary artery lesion and are the independent factors for coronary artery lesion in T2 DM patients.