不同剂量α-硫辛酸对2型糖尿病患者尿足细胞标志蛋白及血管内皮生长因子的影响

Effects of different doses of alpha-lipoic acid on urinary podocalyxin and vascular endothelial growth factor in patients with type 2 diabetes mellitus

目的:探讨不同剂量α-硫辛酸(ALA)对2型糖尿病(T2DM)患者尿足细胞标志蛋白(PCX)、血管内皮生长因子(VEGF)及尿白蛋白(UALB)的影响。方法:92例T2DM患者分为常规治疗组(DM组32例)、ALA治疗组[DM 300mg(30例)及DM 600mg(30例),分别给予ALA 300mg及ALA 600mg静脉滴注,每日一次)。另选34例正常对照者(NC组)。分别于0周及2周测定尿PCX、血VEGF、尿肌酐(Ucr)及UALB。结果:DM 300mg组及DM 600mg组治疗2周后VEGF、尿PCX肌酐比(UPCR)、尿白蛋白肌酐比(UACR)低于DM组(P<0.05或P<0.01),DM 600mg组VEGF、UPCR、UACR低于DM 300mg组(P均<0.05)。结论:ALA可通过抗氧化应激减少尿PCX的排泄,降低血VEGF,减轻足细胞的损伤和凋亡,并呈一定的剂量依赖性。

OBJECTIVE To investigate effects of different doses of alpha-lipoic acid on urinary podocalyxin（PCX）,vascular endothelial growth factors（VEGF）and urinary albumin（UALB）in patients with type 2diabetes mellitus.METHODS Totally 92 patients with type 2diabetes mellitus were randomly divided into three groups：conventional treatment group（DM group,n=32）,alpha-lipoic acid（ALA）300mg treatment group（DM 300 mg,n=30）,and ALA 600 mg treatment group（DM 600 mg,n=30）.All patients in three groups were treated with dietary control and hypoglycemic drugs.Patients in treatment group were given ALA 300mg·d-1 or 600mg·d-1 by intravenous infusion for 2weeks based on initial therapy.Normal control group was also designed（NC,n=34）.Levels of PCX,urinary creatinine（Ucr）,serum VEGF and UALB were determined at baseline and 2weeks after treatment.RESULTS Two weeks later,compared with DM group,levels of serum VEGF,urinary podocalyxin-to-creatinine ratio（UPCR）,and urinary albumin-to-creatinine ratio（UACR）were decreased after alpha-lipoic acid treatment in DM 300 mg group and DM 600 mg group（P〈0.05 or P〈0.01）.Levels of serum VEGF,UPCR and UACR in DM 600 mg group were lower than in DM 300 mg group（P〈0.05）.CONCLUSION ALA can reduce urinary PCX excretion,podocyte injury,apoptosis,and decrease serum VEGF by lowering oxidative stress.