Jain S, Gaiha M, Bhattacharjee J, Anuradha S
Department of Medicine, MAMC and Associated Lok Nayak and GB Pant Hospitals, New Delhi.
J Assoc Physicians India. 2002 Aug;50:1028-33.
A state of increased oxidative stress has been recognised in type 2 diabetes mellitus (DM). The present study was done to assess the effects of low dose omega-3 fatty acids substitution in patients with type 2 DM with special reference to oxidative stress.
Sixty-five patients with type 2 DM of body mass index (BMI) < 27 kg/m2 and thirty age and sex matched healthy controls were evaluated for blood glucose, blood pressure and lipid profile and oxidative stress was assessed in them by measuring lipid peroxides (LP), diene conjugates (DC) and reduced glutathione (RG) in the serum. Of the 65, 40 motivated patients were randomly divided into two groups--group 1 comprising of fifteen patients prescribed a diabetic diet along with a placebo and group 2 consisting of twenty-five patients on the same diet with the addition of 0.6 g omega-3 fatty acids as one capsule Maxigard (containing 180 mg eicosapentaenoic acid and 120 mg docosahexaenoic acid) twice daily. All parameters were reassessed after six weeks.
The levels of lipid peroxides (micromol/L), diene conjugates (OD units) and reduced glutathione (mmol GSH/L) were significantly altered indicating increased oxidative stress in the diabetics compared to the healthy controls: 4.106 +/- 0.889, 2.751 +/- 0.424, 1.344 +/- 0.316 and 1.91 +/- 0.541, 1.735 +/- 0.315, 1.919 +/- 0.310, respectively (p < 0.001 for all the three). Patients in group 1 and 2 were comparable in all respects including oxidative stress at the start of therapy. After six weeks, on comparing the mean % changes in the three parameters of oxidative stress between the two groups, it was seen that the % change was significantly higher in group 2 (Maxigard group) compared to group 1 (Placebo; 5.22 +/- 1.056 (p = 0.05), 3.28 +/- 0.608 (p = 0.01), 5.27 +/- 0.585 (p < 0.001) and 0.82 +/- 0.123, 0.18 +/- 0.017, 0.56 +/- 0.035 (p < 0.001), respectively. The patients in group 2 also exhibited significantly greater improvement in glycemic status, blood pressure and lipid profiles.
The present study documented the existence of a state of increased oxidative stress in type 2 diabetics. Significant beneficial effects of low dose omega-3 fatty acids substitution for PUFA-6 were observed not only on oxidative stress parameters but also on blood pressure and metabolic profile.
2型糖尿病（DM）患者体内存在氧化应激增强的状态。本研究旨在评估低剂量ω-3脂肪酸替代对2型糖尿病患者氧化应激的影响。
对65名体重指数（BMI）<27kg/m²的2型糖尿病患者和30名年龄及性别匹配的健康对照者进行血糖、血压、血脂谱评估，并通过测量血清中的脂质过氧化物（LP）、二烯共轭物（DC）和还原型谷胱甘肽（RG）来评估氧化应激。在这65名患者中，40名有积极性的患者被随机分为两组——第1组由15名患者组成，他们接受糖尿病饮食并服用安慰剂；第2组由25名患者组成，他们接受相同饮食，并每天两次额外服用一粒Maxigard胶囊（含180mg二十碳五烯酸和120mg二十二碳六烯酸），剂量为0.6gω-3脂肪酸。六周后重新评估所有参数。
脂质过氧化物（微摩尔/升）、二烯共轭物（光密度单位）和还原型谷胱甘肽（毫摩尔GSH/升）水平有显著变化，表明与健康对照者相比，糖尿病患者的氧化应激增加：分别为4.106±0.889、2.751±0.424、1.344±0.316和1.91±0.541、1.735±0.315、1.919±0.310（所有三项p<0.001）。第1组和第2组患者在治疗开始时在包括氧化应激在内的所有方面均具有可比性。六周后，比较两组氧化应激三个参数的平均变化百分比，发现第2组（Maxigard组）的变化百分比显著高于第1组（安慰剂组）：分别为5.22±1.056（p=0.05）、3.28±0.608（p=0.01）、5.27±0.585（p<0.001）和0.82±0.123、0.18±0.017、0.56±0.035（p<0.001）。第2组患者在血糖状态、血压和血脂谱方面也有显著更大的改善。
本研究证明2型糖尿病患者存在氧化应激增强的状态。观察到低剂量ω-3脂肪酸替代多不饱和脂肪酸-6不仅对氧化应激参数有显著有益影响，而且对血压和代谢谱也有有益影响。
