氧化应激和糖基化终末产物在2型糖尿病心肌病变中的作用及其相关性

The effect and correlation of oxidative stress and advanced glycation end products in diabetic cardiomyopathy

目的研究氧化应激因素和糖基化终末产物(AGEs)在2型糖尿病(T2DM)心肌病变(DCM)的作用及其相关性。方法选择泰安地区的T2DM患者78例,根据超声心动图、冠状动脉造影等情况,分为单纯T2DM组40例,DCM组38例,另选取正常对照组(NC)40例。测定超氧化物歧化酶(SOD)、丙二醛(MDA)、一氧化氮(NO)以及谷胱甘肽过氧化物酶(GHS-PX)等氧化应激指标和糖基化终末产物(AGEs),进行数据统计,并进行相关性分析。结果 T2DM组SOD、NO、GHS-PX较NC组均明显下降,MDA、AGEs则较NC组均明显升高;而DCM组较T2DM组SOD、GHS-PX明显下降,MDA、AGEs明显升高,差异均有统计学意义(P<0.01),而血清NO水平T2DM组较NC组下降,DCM组再次升高,且高于NC组,差异均有统计学意义(P<0.01)。结论氧化应激因素和AGEs在DCM的进展中均有重要作用,促进DCM的发生和发展,且二者之间有相关性,SOD的下降和MDA的升高是AGEs的独立相关因素。

Objective To study the affection and relationship of oxidative stress and advanced glycation end products （AGEs） in diabetic cardiomyopathy （DCM）. Methods 78 T2DM patients in Tai＇an area were categorizer into two groups based on cardiac color ultrasound and coronary angiogram： 38 cases with DCM, 40 cases T2DM without complications, another 40 subject without T2DM as control group. After measuring oxidative stress indicator such as SOD, MDA, NO, GHS-PX and AGEs, all the data were taken into statistics. Results There was a significant lower SOD, NO, GHS-PX levels and higher MDA, AGEs levels in T2DM group compared to NC group. In the same way, the SOD, NO, GHS-PX levels were significantly lower in DCM group compared to T2DM group and MDA, AGEs levels were significantly higher in DCM group compared to T2DM group （P〈0.01）. The NO level in T2DM group were lower than NC group, it was also significantly lower compared to DCM group as a oxidative stress indicator （P〈0.01）. Conclusion Oxidative stress and AGEs were important factor in DCM and aggravate it＇s progress, SOD and MDA were exclusively correlative factor for AGEs.