α-硫辛酸改善初诊2型糖尿病患者循环内皮祖细胞水平

Alpha-lipoic acid increases circulating endothelial progenitor cells in newly diagnosed type 2 diabetes

背景:前期研究表明,初诊2型糖尿病患者已存在血管内皮功能障碍,α-硫辛酸作为一种抗氧化剂,广泛应用于糖尿病神经病变患者,而其能否改善初诊2型糖尿病患者循环内皮祖细胞的数量与功能,目前尚无这方面的研究。目的:探讨α-硫辛酸对初诊2型糖尿病患者循环内皮祖细胞水平的影响。方法:将50例初诊2型糖尿病患者在基础治疗的前提下,随机分为对照组20例和α-硫辛酸组30例,治疗前和治疗2周检测超氧化物歧化酶、谷胱甘肽过氧物酶、丙二醛、8-羟基脱氧鸟苷、三酰甘油、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇水平及内皮祖细胞数量,分析各指标在两组间的差异及相关性。结果与结论:(1)与治疗前比较,α-硫辛酸组治疗后内皮祖细胞数量、超氧化物歧化酶、谷胱甘肽过氧物酶活性显著增加(P <0.05),丙二醛、8-羟基脱氧鸟苷、三酰甘油、总胆固醇、低密度脂蛋白胆固醇显著降低(P <0.05),高密度脂蛋白胆固醇显著升高(P <0.05);(2)与治疗前比较,对照组治疗后三酰甘油、总胆固醇、低密度脂蛋白胆固醇显著下降(P <0.05),高密度脂蛋白胆固醇显著升高(P <0.05);(3)两组治疗前后的差值比较:α-硫辛酸组较对照组内皮祖细胞数量、超氧化物歧化酶、谷胱甘肽过氧物酶活性显著增加(P <0.05),丙二醛、8-羟基脱氧鸟苷含量显著降低(P <0.05);(4)以α-硫辛酸组治疗前后各指标的差值进行多元线性回归分析显示,谷胱甘肽过氧物酶、丙二醛是内皮祖细胞水平的影响因素;(5)结果表明,α-硫辛酸能够通过抗氧化应激增加初诊2型糖尿病患者循环内皮祖细胞水平。

BACKGROUND:Previous studies have shown that vascular endothelial dysfunction exists in patients with newly diagnosed type2diabetes.Alpha-lipoic acid is widely used as an antioxidant in patients with diabetic neuropathy.Can it improve the number of circulating endothelial progenitor cells in newly diagnosed type2diabetic patients?There is no such report.OBJECTIVE:To investigate the impact ofα-lipoic acid on circulating endothelial progenitor cells in newly diagnosed type2diabetes mellitus.METHODS:Fifty newly diagnosed type2diabetes mellitus patients were randomly divided into control group(n=20)and alpha-lipoic acid group(n=30).Superoxide dismutase,glutathione peroxidase,malondialdehyde,8-hydroxydeoxyguanosine,triacylglycerol,total cholesterol,low-density lipoprotein cholesterol,high-density lipoprotein cholesterol levels and number of endothelial progenitor cells were detected in the two groups before and2weeks after treatment.The differences and correlations between the two groups were analyzed.RESULTS AND CONCLUSION:In the alpha-lipoic acid group,the number of endothelial progenitor cells,superoxide dismutase,glutathione peroxidase and high-density lipoprotein cholesterol levels were significantly increased after treatment compared with the baseline(P<0.05),while the levels of malondialdehyde,8-hydroxydeoxyguanosine,triacylglycerol,total cholesterol and low-density lipoprotein cholesterol were significantly decreased after the treatment(P<0.05).In the control group,the levels of triacylglycerol,total cholesterol and low-density lipoprotein cholesterol were significantly reduced after treatment compared with the baseline(P<0.05),while the level of high-density lipoprotein cholesterol increased significantly after treatment(P<0.05).Compared with the control group,the number of endothelial progenitor cells,superoxide dismutase and glutathione peroxidase levels were significantly increased in the alpha-lipoic acid group(P<0.05),while the levels of malondialdehyde and8-hydroxydeoxyguanosine were decreased in the alpha-lipoic acid group(P<0.05).Multivariate linear regression analysis of the differences of the indexes before and after treatment in the alpha-lipoic acid group showed that the number of endothelial progenitor cells was correlated with the levels of glutathione peroxidase and malondialdehyde.To conclude,the treatment withα-lipoic acid increases the number of circulating endothelial progenitor cells in newly diagnosed type2diabetes mellitus,which is associated with antioxidative stress.