初诊老年2型糖尿病患者血糖波动对氧化应激的影响

Effect of glucose variability on oxidative stress in newly-diagnosed elderly patients with T2DM

目的：观察初诊老年2型糖尿病患者血糖波动对氧化应激的影响，比较分析瑞格列奈与格列齐特对患者血糖波动及氧化应激的影响。方法将2013年1~12月60例初诊老年2型糖尿病患者分为瑞格列奈组和格列齐特组各30例。分别予以瑞格列奈和格列齐特治疗8周，采用动态血糖监测系统的日内平均血糖波动幅度（MAGE）以及日间血糖平均绝对差（MODD）评估血糖波动，同时测定谷胱甘肽过氧化物酶（GSH-Px）、超氧化物歧化酶（SOD）、丙二醛（MDA）以反映患者氧化应激水平。结果老年2型糖尿病患者血清GSH-Px、SOD水平与MAGE、MODD呈负相关（P＜0.05），MDA水平与MAGE、MODD呈正相关（P＜0.01）。瑞格列奈组和格列齐特组治疗后MAGE、MODD、MDA水平降低，血清GSH-Px、SOD水平增加，各指标与治疗前比较，差异均有统计学意义（P＜0.01）；但两组治疗后比较，差异无统计学意义（P＞0.05）。结论初诊老年2型糖尿病患者血糖波动与氧化应激水平存在显著相关性。瑞格列奈与格列齐特均可降低初诊老年2型糖尿病患者的血糖波动及氧化应激水平，2种药物疗效相似。

Objective To investigate the effect of glucose variability on oxidative stress in newly-diagnosed elderly pa-tients with type 2 diabetes mellitus（T2DM）,and compare the influence of repaglinide and gliclazide on glucose variability and ox-idative stress. Methods A total of 60 elderly patients with newly-diagnosed T2DM from January to December of 2013 were divid-ed into repaglinide group and gliclazide group,30 cases in each group,which received repaglinide and gliclazide respectively for 8-week treatment. The glucose variability was evaluated by mean amplitude of glycemic excursions （MAGE） and mean of daily differences（MODD） of continuous glucose monitoring system（CGMS）,meanwhile to detect the Glutathione Peroxidase（GSH-Px）, Superoxide Dismutase（SOD） and Maleic Dialdehyde（MDA） to reflect the level of oxidative stress. Results The levels of GSH-Px and SOD in elderly patients with T2DM were negatively related with MAGE and MODD（P〈0.05）,while the MDA level was positively related with MAGE and MODD（P〈0.01）. The levels of MAGE,MODD and MDA in both groups decreased after treat-ment,and the levels of serum GSH-Px and SOD increased,the difference of above indicators in both groups before and after treat-ment had statistical significance（P〈0.01）,but the comparison between the two groups on the above indicators showed no statisti-cally significant difference（P＆gt;0.05）. Conclusion The serum oxidative stress levels are significantly correlated with glucose variability in newly-diagnosed elderly patients with T2DM. Both repaglinide and gliclazide can reduce the amplitude of glucose variability and oxidative stress levels in newly-diagnosed elderly patients with T2DM with similar effect.