摘要
目的探讨2型糖尿病肾病患者血糖波动与氧化应激的相关性。方法选取2011年12月—2013年3月在我院内分泌科住院的血糖控制良好〔糖化血红蛋白(HbA1c)<7%〕的2型糖尿病患者120例,根据尿微量清蛋白排泄率(UAER)将患者分为3组:正常清蛋白尿组(DM组,UAER<20μg/min,40例)、微量清蛋白尿组(NA组,20μg/min≤UAER<200μg/min,40例)和大量清蛋白尿组(MA组,UAER≥200μg/min,40例)。另选取同期在我院体检中心进行体检的健康者30例为正常对照组(NC组)。收集4组受检者的一般临床资料并检测氧化应激〔超氧化物歧化酶(SOD)、丙二醛(MDA)〕水平,对糖尿病患者行动态血糖监测,计算日内平均血糖波动幅度(MAGE)和日间血糖平均绝对值(MODD)。结果 4组受检者MAGE、MODD及SOD、MDA水平比较,差异均有统计学意义(P<0.01);其中DM组、NA组、MA组MAGE〔(4.1±1.3)、(5.9±2.4)、(6.9±1.6)mmol/L〕、MODD〔(2.3±0.3)、(4.0±0.5)、(5.0±0.4)mmol/L〕逐渐升高,组间两两比较差异均有统计学意义(P<0.05);NC组、DM组、NA组、MA组SOD水平〔(93±14)、(80±12)、(77±11)、(72±12)kU/L〕逐渐下降,而MDA水平〔(2.5±1.0)、(4.0±0.8)、(6.0±1.2)、(7.4±1.0)nmol/L〕则逐渐升高,组间两两比较差异均有统计学意义(P<0.05)。相关性分析显示,2型糖尿病肾病患者MAGE、MODD均与SOD水平呈负相关(r=-0.431、-0.527,P<0.05),而与MDA水平呈正相关(r=0.532、0.625,P<0.05)。结论在血糖控制良好的2型糖尿病肾病患者中,血糖波动参与了糖尿病肾病的发生、发展,其机制与氧化应激相关。
Objective To explore the correlation between blood glucose fluctuation and oxidative stress in patients with type 2 diabetic nephropathy. Methods From December 2011 to March 2013, 120 patients with type 2 diabetes mellitus （ HbA1c 〈 7% ） were treated in Endocrinology Department of the First Hospital of Hebei Medical University, their blood sugar levels were controlled well, they were divided into three groups according to their uriary albumin excretion rates （UAER） ： normal UAER group （DM group, UAER 〈20 μg/min, 40 cases）, microalbuminuria group （NA group, 20 μg/min≤UAER 〈 200 μg/min, 40 cases）, and macroalbuminuria group （MA group, UAER≥200 μg/min, 40 cases）, and thirty healthy phys- ical examiners were included in control group （NC group）. The general clinical data and oxidative stress level （SOD and MDA） were observed among four groups, and mean amplitude glycemic excursions （ MAGE）, mean of daily differences （MODD） were measured in diabetic patients with continuous glucose monitoring system （CGMS）. Results There were statistical significances in the four groups in MAGE, MODD, SOD and MDA levels （P〈0.01）. The MAGE in DM, NA and MA groups were （4. 1 ±1.3）, （5.9±2.4）, （6.9±1.6） mmol/L, and the MODDwere （2.3 ±0.3）, （4.0±0.5）, （5.0±0.4） mmol/L, separately, the MAGE and MODD increased in group sequence, significant differences of MAGE and MODD levels were found between groups （P〈0.05）. The levels of SOD in NC, DM, NA and MA groups were （93 ±14） , （80±12） , （77 ±11） , （72 ± 12） kU/L, separately, the levels of SOD decreased in group sequence, significant difference of SOD level was found be- tween groups （P〈0.05）. The levels ofMDAinNC, DM, NA and MA groups were （2.5 ±1.0）, （4.0±0.8）, （6.0 ± 1. 2） , （7.4 ±1.0） nmol/L, separately, the levels of MDA increased in group sequence, significant difference of MDA lev- el was found between groups （ P 〈 0. 05 ）. Correlation analysis showed that MAGE and MODD were negatively correlated with SOD （ r = - 0.431 and - 0. 527, both P 〈 0. 05 ）, and were positively correlated with MDA level （r = 0. 532 and 0. 625, both P 〈 0. 05 ）. Conclusion Among patients with type 2 diabetes mellitus nephropathy whose blood sugar levels were controlled well, blood glucose fluctuation involved in the occurrence and development of type 2 diabetic nephropathy, and the mechanism may be related to oxidative stress.
出处
《中国全科医学》
CAS
CSCD
北大核心
2013年第29期3410-3413,共4页
Chinese General Practice
基金
河北省科学技术研究与发展计划项目(122777152)
关键词
糖尿病肾病
氧化性应激
丙二醛
超氧化物歧化酶
血糖波动
Diabetic nephropathies
Oxidative stress
Malondialdehyde
Superoxide dismutase
Blood glucose fluc-tuation
