Dordević Gordana, Durić Stojanka, Apostolskit Slobodan, Dordević Vidosava, Zivković Miroslava
Klinicki centar, Klinika za neurologiju, Nis, Srbija.
Vojnosanit Pregl. 2008 Sep;65(9):663-9. doi: 10.2298/vsp0809663d.
BACKGROUND/AIM: Reduced systemic antioxidant defence is considerd to play an important mediating role in pathogenesis of diabetic neuropathy. The aim of this study was to evaluate if the total antioxidant blood capacity (TAC) is reduced in patients with type 2 diabetes mellitus (DM) and diabetic distal symmetrical polyneuropathy (DDSP) and to correlate this antioxidant capacity with the degree of peripheral nerve dysfunction.
This study involved 100 patients with type 2 DM and signs of DDSP, as well as the control group of 50 healthy subjects. The evaluation of DDSP was based on physical examination and nerve conduction studies. The degree of peripheral nerve dysfunction was estimated by scoring and analysing sensory and motor nerve conduction parameters (distal latency and amplitude of evoked potential, conduction velocity). Laboratory analyses involved blood glucose and HbA1C levels, as well as plasma TAC.
Blood glucose and HbA1C level was significantly higher in the patients than in the control group (p < 0.0001). The TAC was depleted in the diabetic group and the depletion was statistically significant (p < 0.0001). There was no significant correlation between the TAC and the serum glucose level, TAC and HbA1C level as well as between TAC and the duration of DM. There was no significant correlation between TAC and peripheral nerve conduction parameters.
Total antioxidant blood capacity is reduced in patients with DDSP, but it does not correlate with blood sugar level, with the duration of DM or with the degree of functional nerve damage. These results show a reduced systemic antioxidant defence in patients with type 2 DM and DDSP. However, it is still unclear to what extent the oxidative stress is a contributing factor or leading cause of diabetic neuropathy, suggesting that further studies are necessary.
背景/目的：全身抗氧化防御能力降低被认为在糖尿病性神经病变的发病机制中起重要的介导作用。本研究的目的是评估2型糖尿病（DM）和糖尿病性远端对称性多发性神经病变（DDSP）患者的血液总抗氧化能力（TAC）是否降低，并将这种抗氧化能力与周围神经功能障碍的程度相关联。
本研究纳入了100例患有2型DM且有DDSP体征的患者，以及50名健康受试者作为对照组。DDSP的评估基于体格检查和神经传导研究。通过对感觉和运动神经传导参数（远端潜伏期、诱发电位幅度、传导速度）进行评分和分析来评估周围神经功能障碍的程度。实验室分析包括血糖和糖化血红蛋白水平，以及血浆TAC。
患者的血糖和糖化血红蛋白水平显著高于对照组（p < 0.0001）。糖尿病组的TAC降低，且这种降低具有统计学意义（p < 0.0001）。TAC与血糖水平、TAC与糖化血红蛋白水平以及TAC与DM病程之间均无显著相关性。TAC与周围神经传导参数之间也无显著相关性。
DDSP患者的血液总抗氧化能力降低，但它与血糖水平、DM病程或神经功能损害程度均无相关性。这些结果表明2型DM和DDSP患者的全身抗氧化防御能力降低。然而，氧化应激在多大程度上是糖尿病性神经病变的促成因素或主要原因仍不清楚，这表明有必要进行进一步研究。
