糖尿病周围神经病变氧化应激等相关机制探讨

Investigation the mechanism of oxidative stress in diabetic peripheral neuropathy

目的探讨氧化应激在糖尿病周围神经病变(diabetic peripheral neuropathy,DPN)机制中的作用。方法总结50例DPN患者与27例2型糖尿病非周围神经病变(NDPN)患者临床资料,包括收缩压(SBP)、舒张压(DBP)、体质指数(BMI)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、糖化血红蛋白(Hb A1c)、空腹血糖(FPG)、餐后2 h血糖(2h PG)、空腹C肽(FC-P)、2 h C肽(2h C-P)水平。测定并分析患者血清总抗氧化能力(T-AOC)、丙二醛(MDA)及超氧化物歧化酶(SOD)水平。对有统计学意义的危险因素进行Logistic多元回归分析,以发现DPN发生的危险因素。结果 DPN组与NDPN组比较,性别、BMI、SBP、DBP、2h PG、FC-P、TC、HDL-C、LDL-C、Hb A1c、T-AOC差异均无统计学意义(P>0.05),而年龄、病程、FPG、TG、2h C-P、SOD、MDA有显著差异(P<0.05);多因素Logistic回归分析年龄、TG、2h C-P、MDA进入回归方程;MDA、SOD与TCSS评分呈相关性(P<0.05)。结论年龄、TG、2h C-P、MDA是DPN发生的独立危险因素;血清SOD水平的下降、MDA水平的增高与DPN的发生及神经病变程度显著相关,氧化应激在DPN发病机制中起重要作用。

Objective To investigate the role of oxidative stress in the mechanism of diabetic peripheral neuropa-thy （DPN） and to analyze the risk factors for the development of DPN. Methods Fifty DPN patients and 27 patients diag-nosed with type 2 diabetes mellitus （T2DM） without DPN （NDPN） were enrolled into this study. The clinical data of pa-tients, including systolic pressure （SBP）, diastolic pressure （DBP）, body mass index （BMI）, triglyceride （TG）, total choles-terol （TC）, high density lipoprotein cholesterol （HDL-C）, low density lipoprotein cholesterol （LDL-C）, Hemoglobin A1C （HbA1c）, fasting plasma glucose （FPG）, 2-hour postprandial plasma glucose （2hPG）, fasting C peptide （FC-P）, 2-hour C peptide （2hC-P） were recorded and analyzed. Total antioxidant capacity （T-AOC）, Malondialdehyde （MDA） and superoxide dismutase （SOD） levels were examined to evaluate the level of oxidative stress. The risk factors with statistical significance were subjected to multiple Logistic regression analysis to screen for the risk factors for DPN. Results There was no signif-icant difference in sex, BMI, SBP, DBP, 2hPG, FC-P, TC, HDL-C, LDL-C, HbA1c, T-AOC between the 2 groups of pa-tients （P 〉0.05）, while age, duration of DM, FPG, TG, 2hC-P, SOD, MDA were statistically different （P 〈 0.05）. By multi-factor Logistic regression analysis, age, TG, 2hC-P, MDA came into the regression equation;MDA and SOD cor-related with the TCSS score （P〈 0.05）. Conclusion Age, TG, 2hC-P, MDA levels are the independent risk factors for DPN, The decrease of SOD level and increase of MDA are interrelated with DPN, and the levels of SOD and MDA are as-sociated with the degree of functional nerve damage. Oxidative stress plays an important role in the pathogenesis of DPN.