血糖波动对老年糖尿病患者氧化应激指标及胰岛β细胞功能的影响

Effect of blood glucose ?uctuation on oxidative stress indexes and islet beta cell function in elderly diabetic patients

目的检测老年糖尿病患者氧化应激和动态血糖监测(CGMS)相关指标,探讨血糖波动与老年糖尿病患者胰岛β细胞分泌功能之间关系。方法选取2015-01至2016-01上海市浦东新区周浦医院内分泌科住院的老年糖尿病患者60例,应用CGMS进行连续72 h血糖监测,同时检测血清胰岛素、糖化血红蛋白(HbA1c)、血浆丙二醛含量(MDA)、超氧化物歧化酶水平(SOD)、8-异前列腺素F2α(8-iso-PGF2α)等。根据CGMS数据计算平均血糖波动幅度(MAGE),胰岛β细胞功能采用稳态模式评估法的胰岛素分泌指数(HOMA-β)表示。结果 MAGE与HOMA-β、SOD呈负相关(P <0.05)、与8-iso-PG、MAD呈正相关(P <0.05),MAGE与HbA1c无明显相关(P> 0.05),多元逐步回归分析显示HOMA-β与MAGE、体质量指数(BMI)相关。结论老年糖尿病患者血糖波动与胰岛素分泌缺陷密切相关,血糖波动可能通过氧化应激这一关键环节加重对胰岛β细胞功能的损害。

Objective To detect indexes related to oxidative stress and continuous glucose monitoring system(CGMS)in elderly patients with diabetes,and to investigate the relationship between blood glucose fluctuation and islet beta cell secretion function in elderly patients with diabetes mellitus.Methods From January 2015 to January 2016,60 elderly diabetic patients treated at the Department of Endocrinology of our hospital selected.The CGMS was used for 72-h continuous glucose monitoring.Serum insulin,glycosylated hemoglobin(HbA1c),plasma malondialdehyde(MDA),superoxide dismutase(SOD),and 8-iso-prostaglandin F2 alpha(8-iso-pgf2a)were also detected.The CGMS data were used to calculate the average blood glucose fluctuation range(MAGE),and islet beta cell function was assessed using the homeostasis model assessment of insulin secretion index(HOMA-β).Results MAGE data had a negative correlation with HOMA-βand SOD(P<0.05),but had a positive correlation with 8-iso-PG and MAD(P<0.05).There was no significant correlation between MAGE and HbA1c(P>0.05).Multiple stepwise regression analysis showed that HOMA-βwas related to MAGE and body mass index(BMI).Conclusion Blood glucose fluctuation is closely related to insulin secretion defects in elderly patients with diabetes mellitus.Blood glucose fluctuation may aggravate the damage of islet beta cell function through oxidative stress.