不同糖耐量人群体内氧化应激水平与血糖及胰岛功能的相关性研究

Correlation Between Oxidative Stress and Blood Glucoseand Islet Function Among Patient with Different Glucose Tolerance

目的研究2型糖尿病患者体内氧化应激水平与血糖及胰岛功能的相关性。方法本研究观察对象为2015年2月至2017年2月于我院确诊的60例2型糖尿病患者、选择同期健康体检人群中糖耐量受损者、糖耐量正常者各50例作为对照正常组。比较三组血清丙二醛(MDA)、8-异前列腺素2a(8-iso-PGF2a)等氧化应激指标;采用动态血糖临测系统(CGMS)检测三组糖化血红蛋白(HbAlc%)、空腹血糖(FPG)、餐后2h血糖(2hPG)、日内血糖波动幅度(MAGE)、日间血糖平均绝对差(MODD)日内平均餐后血糖漂移幅度(MPPCE)等血糖指标;检测两组胰岛素抵抗指数(HOMA-IR)及胰岛β细胞功能指数(HOMA-B)、空腹胰岛素(FIns)、C肽(FCP)水平等胰岛功能指标,采用Pearson相关分析探索氧化应激指标与血糖指标、胰岛功能指标相关性。结果 T2DM组、糖耐量受损组血清MDA、8-iso-PGF2a水平均显著高于糖耐量正常组,T2DM组显著高于糖耐量受损组,差异具有统计学意义(P <0. 05);T2DM组、糖耐量受损组MAGE、MODD、MPPCE、HbAlc%、FPG、2hPG均显著高于糖耐量正常组,T2DM组显著高于糖耐量受损组,差异具有统计学意义(P <0. 05);T2DM组、糖耐量受损组HOMA-B、FIns、FCP水平均显著低于糖耐量正常组,HOMA-IR显著高于糖耐量正常组,差异具有统计学意义(P<0.05);血清MDA、8-iso-PGF2a分别与MAGE、MODD、MPPCE、HbAlc%、FPG、2hPG、HOMA-IR呈正相关(r值依次为0.342、0.198、0.332、0.332、0.434、0.468、0.322和0.365、0.189、0.376、0.341、0.428、0.454、0.334,P均<0.05或P<0.01),而与HOMA-B、FIns、FCP水平均呈负相关(r值为-0.201、-0.221、-0.265和-0.221、-0.298、-0.287,P均<0.05或P<0.01)。结论不同糖耐量人群其氧化应激严重程度、血糖及胰岛功能存在差异,氧化应激与血糖及胰岛功能存在相关性,揭示氧化应激反应可能参与了T2DM的发生发展。

Objective To investigate the correlation between oxidative stress and blood glucose and islet function in type 2 diabetic patients. Methods 60 patients with type 2 diabetes mellitus (T2DM group),50 impaired glucose tolerance (impaired group)and 50 normal glucose tolerance (normal control group)in our hospital from February 2015 to February 2017 were selected for the study.The levels of malondialdehyde (MDA),8-iso-prostaglandin 2a (8-iso-PGF2a)and other oxidative stress indexes of three groups were then compared.Glucose monitoring system was applied to monitor the glycosylated hemoglobin (HbAlc),fasting plasma glucose (FPG),2 hour postprandial plasma glucose (2h PPG),mean amplitude of glycemic excursions (MAGE),absolute means of daily differences (MODD),and mean of postprandial glucose excursion (MPPGE);The homeostasis model assessment of insulin resistance (HOMA-IR),homa-β cell function index (HOMA-β),fasting insulin (FIns)and fasting C-peptide (FCP)levels were detected.Then Pearson correlation and multivariate regression analysis were performed among oxidative stress and blood glucose and islet function. Results The levels of MDA and 8-iso-PGF2a in three groups from high to low were T2DM group,the impaired group and the normal control group,respectively( P <0.05);The MAGE,MODD,MPPCE,HbAlc%,FPG and 2hPG levels in three groups from high to low were T2DM group,the impaired group and the normal control group,respectively( P <0.05);The T2DM group and the impaired group had higher level of HOMA-IR and lower levels of HOMA-B,FIns and FCP,compared with those in the control group ( P <0.05);The levels of MDA and 8-iso-PGF2a were positively correlated with MAGE,MODD,MPPCE,HbAlc%,FPG and 2hPG levels ( r =0.342,0.198,0.332,0.332,0.434,0.468,0.322 and 0.365,0.189,0.376,0.341,0.428,0.454,0.334,all P <0.05 or P <0.01),and were negatively correlated with HOMA-B,FIns and FCP levels ( r =-0.201,-0.221,-0.265,-0.221,-0.298,-0.287, P <0.05 or P <0.01). Conclusion The oxidative stress severity,blood glucose and islet function are different among different glucose tolerance subjects.The oxidative stress level is correlated with blood glucose and islet function,suggesting that oxidative stress may be involved in the occurrence and development of T2DM.