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糖尿病患者的氧化应激状态:与饮食的关系

Oxidative stress status in patients with diabetes mellitus: relationship to diet.

作者信息

Dierckx N, Horvath G, van Gils C, Vertommen J, van de Vliet J, De Leeuw I, Manuel-y-Keenoy B

机构信息

Laboratory of Endocrinology, University of Antwerp, Belgium.

出版信息

Eur J Clin Nutr. 2003 Aug;57(8):999-1008. doi: 10.1038/sj.ejcn.1601635.

Abstract

OBJECTIVE

To investigate the relationship between dietary intakes and in vivo oxidative stress (OS) status in diabetic patients.

DESIGN

Case-control study.

SETTING

Outpatient-Clinic and Laboratory Endocrinology, University Antwerp.

SUBJECTS AND METHODS

A total of 30 patients (24 type 1 diabetes mellitus (T1DM)/6 type 2 diabetes mellitus (T2DM) were asked to complete a 2 weekdays+1 weekend day food consumption questionnaire during the week preceding their yearly diabetes control consultation, when samples were collected for the assay of oxidative stress (OS) (blood levels of antioxidants, peroxides, malondialdehyde (MDA) and minerals). Blood samples were also collected from 25 age- and sex-matched healthy controls.

RESULTS

Diabetic patients had lower glutathione (5.80+/-1.15 vs 6.75+/-1.03 micromol/g Hb in the controls, P=0.002) and higher MDA (0.687+/-0.212 vs 0.545+/-0.101 micromol/l, P=0.002). Although the group average intakes were within the Belgian RDA, intakes of fat >35% energy, fibre <15 g/1000 kcal, fruit <2 portions and vitamin E <10 mg/day were seen in more than 20 patients. Blood antioxidants did not correlate with intakes of energy, fat, protein or fibres or of their respective antioxidant. Vitamins A and E correlated with serum lipids (r=0.58, P <0.0005 between serum alpha-tocopherol and cholesterol). Blood peroxide levels were only related to intakes of saturated fat and cholesterol (P<0.05). In diabetic subjects but not in controls (P<0.05) MDA was related to glutathione and uric acid.

CONCLUSIONS

In diabetic patients, blood levels of antioxidants are not related to their dietary intakes but to serum lipids. Levels of oxidative damage products are only related to intakes of saturated fats and cholesterol and to levels of endogenous antioxidants.

摘要

目的

研究糖尿病患者的饮食摄入与体内氧化应激(OS)状态之间的关系。

设计

病例对照研究。

地点

安特卫普大学门诊内分泌科及实验室。

研究对象与方法

共有30例患者(24例1型糖尿病(T1DM)/6例2型糖尿病(T2DM))被要求在年度糖尿病控制会诊前一周,完成一份为期2个工作日加1个周末日的食物消费问卷,同时采集样本用于氧化应激(OS)检测(血液中的抗氧化剂、过氧化物、丙二醛(MDA)和矿物质水平)。还从25名年龄和性别匹配的健康对照者中采集了血样。

结果

糖尿病患者的谷胱甘肽水平较低(对照组为6.75±1.03微摩尔/克血红蛋白,糖尿病患者为5.80±1.15微摩尔/克血红蛋白,P = 0.002),而MDA水平较高(对照组为0.545±0.101微摩尔/升,糖尿病患者为0.687±0.212微摩尔/升,P = 0.002)。尽管该组平均摄入量在比利时推荐膳食摄入量范围内,但超过20例患者脂肪摄入量>能量的35%、纤维摄入量<15克/1000千卡、水果摄入量<2份且维生素E摄入量<10毫克/天。血液中的抗氧化剂与能量、脂肪、蛋白质或纤维及其各自的抗氧化剂摄入量无关。维生素A和E与血脂相关(血清α-生育酚与胆固醇之间的r = 0.58,P < 0.0005)。血液过氧化物水平仅与饱和脂肪和胆固醇摄入量相关(P < 0.05)。在糖尿病患者中,而非对照组中(P < 0.05),MDA与谷胱甘肽和尿酸相关。

结论

在糖尿病患者中,血液中的抗氧化剂水平与其饮食摄入量无关,而与血脂有关。氧化损伤产物水平仅与饱和脂肪和胆固醇摄入量以及内源性抗氧化剂水平有关。

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