氢气对社区糖尿病患者氧化应激的作用及影响因素

Effect of hydrogen on oxidative stress and its influencing factors in community patients with diabetes mellitus

目的探讨氢气对社区糖尿病患者氧化应激的作用及其影响因素。方法选取2016年6月—2017年9月社区2型糖尿病患者76例,每天给予患者饮用富氢水500 m L,连续饮用30 d。检测干预前后活性氧(ROS)、丙二醛(MDA)、谷胱甘肽过氧化物酶(GSH-PX)和SOD水平,比较干预前后患者血清氧化应激指标的变化,分析氢气抗氧化作用的相关影响因素。结果干预后,患者血清ROS和MDA水平低于干预前,GSH-PX和SOD活性高于干预前(均P<0.05);氢气对吸烟患者氧化应激的抑制作用强于不吸烟患者(均P<0.05)。氢气降低MDA的程度与干预前患者Hb A1c和LDL水平呈低度线性正相关(r=0.289,0.221,均P<0.05),氢气降低ROS的能力与患者病程和干预前Hb A1c水平呈低度线性正相关(r=0.221,0.301,均P<0.05),GSH-PX的升高程度与干预前LDL水平呈低度线性正相关(r=0.241,P<0.05)。患者的年龄、BMI、平均动脉压、空腹血糖、HDL和IL-1/6水平与氢气对2型糖尿病的抗氧化作用无相关性(均P>0.05)。结论氢气能降低2型糖尿病患者体内的氧化水平,减轻过氧化损伤,病程、吸烟、Hb A1c和LDL水平可能成为社区医生在2型糖尿病患者中选择最适合氢气治疗病例的参考指标。

Objective To explore the effect of hydrogen on oxidative stress in diabetic patients in community and its influencing factors.Methods A total of 76 patients with type 2 diabetes were selected from June 2016 to September 2017, and the patients were given hydrogen rich water 500 m L per day for 30 consecutive days. The levels of reactive oxygen species（ROS）, malondialdehyde（MDA）, glutathione peroxidase（GSH-PX） and SOD were measured and compared before and after intervention, and the related factors of hydrogen oxidation resistance were analyzed.Results After the intervention, the serum levels of ROS and MDA were lower than before the intervention, and the activity of GSH-PX and SOD was higher than that before the intervention（all P〈0.05）. The inhibition of hydrogen on oxidative stress in smoking patients was stronger than that of non smoking patients（all P〈0.05）. The degree of hydrogen reduction of MDA was low linear positive correlation with the level of Hb A1 c and LDL before intervention（r=0.289, 0.221, all P〈0.05）. The ability of hydrogen to reduce ROS was low linear positive correlation with patients＇ course of disease and Hb A1 c level before intervention（r=0.221, 0.301, all P〈0.05）, and the elevation of GSH-PX was lower than that before intervention. Sexual positive correlation（r=0.241, P〈0.05）. Age, BMI, mean arterial pressure, fasting blood glucose, HDL,IL-1 and IL-6 levels were not correlated with the antioxidant effect of hydrogen on type 2 diabetes（all P〉0.05）.Conclusion Hydrogen can reduce the level of oxidation in type 2 diabetic patients and reduce peroxidation damage. The course of disease, smoking, Hb A1 c and LDL may be the reference index for community doctors to choose the most suitable hydrogen treatment cases in type 2 diabetic patients.