Sayın Refah, Aslan Mehmet, Kucukoglu Mehmet Emin, Luleci Arda, Atmaca Murat, Esen Ramazan, Demir Halit
Department of Neurology, Medical Faculty, Yuzuncu Yil University, Van, Turkey.
Endocrine. 2014 Sep;47(1):146-51. doi: 10.1007/s12020-013-0136-3. Epub 2013 Dec 18.
Previous studies have suggested that prolidase and nitric oxide (NO) regulate many processes, such as collagen synthesis and matrix remodeling. Oxidative stress plays an important role in the development of microvascular complications in diabetic patients. Data on serum prolidase activity in patients with diabetes mellitus or diabetic neuropathy (DN) are limited and conflicting. The aim of this study was to measure serum prolidase activity, NO, total antioxidant status (TAS), and malondialdehyde (MDA) levels in patients with DN. Forty-five patients with DN and 40 healthy controls were enrolled. Serum prolidase activity, TAS, MDA, and NO levels were determined. Serum MDA and NO levels were significantly higher in DN patients than controls (p = 0.002, p = 0.001, respectively), while prolidase activity and TAS levels were lower (p = 0.003, p = 0.001, respectively). Prolidase activity was negatively correlated with NO and MDA (r = -0.911, p < 0.001; r = -0.905, p < 0.001, respectively), while positively correlated with TAS (r = 0.981, p < 0.001) in DN patients. The current study is the first showing the decreased serum prolidase enzyme activity. Our results suggest that decreased collagen turnover may occur in DN patients, who have increased oxidative stress and increased NO levels. Decreased prolidase activity seems to be associated with increased NO levels and oxidative stress along with decreased antioxidant levels in DN. Therefore, decreased prolidase activity may play a role in pathogenesis of DN. Prospective clinical studies are necessary to confirm these findings.
先前的研究表明，脯氨酰寡肽酶和一氧化氮（NO）调节许多过程，如胶原蛋白合成和基质重塑。氧化应激在糖尿病患者微血管并发症的发生发展中起重要作用。关于糖尿病或糖尿病神经病变（DN）患者血清脯氨酰寡肽酶活性的数据有限且相互矛盾。本研究的目的是测量DN患者的血清脯氨酰寡肽酶活性、NO、总抗氧化状态（TAS）和丙二醛（MDA）水平。纳入了45例DN患者和40例健康对照者。测定血清脯氨酰寡肽酶活性、TAS、MDA和NO水平。DN患者的血清MDA和NO水平显著高于对照组（分别为p = 0.002，p = 0.001），而脯氨酰寡肽酶活性和TAS水平较低（分别为p = 0.003，p = 0.001）。在DN患者中，脯氨酰寡肽酶活性与NO和MDA呈负相关（分别为r = -0.911，p < 0.001；r = -0.905，p < 0.001），而与TAS呈正相关（r = 0.981，p < 0.001）。本研究首次表明血清脯氨酰寡肽酶活性降低。我们的结果表明，DN患者可能发生胶原蛋白周转减少，这些患者氧化应激增加且NO水平升高。脯氨酰寡肽酶活性降低似乎与DN患者NO水平升高和氧化应激增加以及抗氧化水平降低有关。因此，脯氨酰寡肽酶活性降低可能在DN的发病机制中起作用。需要进行前瞻性临床研究来证实这些发现。
