2型糖尿病患者谷胱甘肽催化反应体系改变及临床意义

Change of glutathione catalytic reaction system and its clinical significance in patients with type 2 diabetes

目的分析2型糖尿病(T2DM)患者谷胱甘肽催化反应体系改变情况,评价还原型谷胱甘肽治疗T2DM的效果。方法选择2014年10月至2015年6月确诊的T2DM患者86例(T2DM组)和健康人群86例(对照组),检测其血清过氧化氢(H_2O_2)、过氧化脂(LPO)含量及超氧化物歧化酶(SOD)、谷胱甘肽(GSH)、GSH过氧化物酶(GSH-Px)和谷胱甘肽还原酶(GR)活性;将T2DM组患者随机分为GSH组(给予还原型GSH治疗)和非GSH组(给予B族维生素治疗),每组43例。治疗2周后比较两组的SOD活性、糖化血红蛋白(Hb Alc)含量、感觉神经传导速度(SCV)和尿蛋白排泄率(UAER)水平的变化情况。结果 T2DM组患者的H_2O_2和LPO含量分别为(3.66±0.81)nmol/L和(6.35±1.43)nmol/L,明显高于对照组的(2.23±0.24)nmol/L和(4.14±0.86)nmol/L,组间比较差异有统计学意义(P均<0.01);T2DM组患者的SOD、GSH、GSH-Px及GR活性分别为(41.36±4.72)nu/ml、(3.87±1.56)μg/L、(0.28±0.05)ng/L和(0.19±0.06)ng/L,显著低于对照组的(81.47±9.73)nu/ml、(4.46±1.93)μg/L、(0.36±0.09)ng/L和(0.27±0.09)ng/L,组间比较差异有统计学意义(P均<0.01);治疗2周后,GSH组患者的SOD活性、Hb Alc、SCV及UAER明显优于非GSH组(P<0.05,P<0.01)。结论 T2DM患者谷胱甘肽催化反应体系改变明显,给予还原型GSH治疗能有效提高T2DM患者的SOD活性,改善SCV和UAER水平。

Objective To analyze the changes of glutathione catalytic reaction system in patients with type 2 diabetes（ T2DM） and evaluate the effect of reduced glutathione（ GSH） for the treatment of T2DM. Methods A total of 86 T2DM patients definitely diagnosed between October 2014 and June 2015 were selected as T2DM group,and 86 healthy subjects were selected as control group. The serum contents of hydrogen dioxide（ H2O2） and lipid peroxidation（ LPO）,and the activities of superoxide dismutase（ SOD）,GSH,GSH-peroxidase（ GSH-Px） and glutathione reductase（ GR） were detected.The T2DM patients were randomly divided into two groups（ n = 43 each） according to treatment method： GSH group（ treatment with reduced glutathione） and non-GSH group（ treatment with Vitamin B Complex）. Two weeks after treatment,the activity of SOD,the glycosylated hemoglobin（ HbAlc） level,the sensory nerve conduction velocity（ SCV） and urinary albumin excretion rate（ UAER） in two groups were compared. Results Before treatment,the serum contents of H2O2 and LPO[（ 3. 66 ± 0. 81） nmol/L,（ 6. 35 ± 1. 43） nmol/L] in T2DM group were significantly higher than those in control group[（ 2. 23 ± 0. 24） nmol/L,（ 4. 14 ± 0. 86） nmol/L]（ all P 〈 0. 01）; the activities of SOD,GSH,GSH-Px and GR[（ 41. 36 ± 4. 72） nu/ml,（ 3. 87 ± 1. 56） μg/L,（ 0. 28 ± 0. 05） ng/L and（ 0. 19 ± 0. 06） ng/L]in T2DM group were significantly lower than those in control group [（ 81. 47 ± 9. 73） nu / ml,（ 4. 46 ± 1. 93） μg / L,（ 0. 36 ± 0. 09） ng / L and（ 0. 27 ±0. 09） ng / L]（ all P 〈 0. 01）. Two weeks after treatment,the activity of SOD,the Hb Alc level,the SCV and UAER in GSH group were all significantly better than those in non-GSH group（ all P 〈 0. 05）. Conclusion The glutathione catalytic reaction system in T2DM patients has obvious changes,and the therapy of reduced GSH can effectively raise the activity of SOD and improve SCV and UAER level.