餐后氧化应激与胃肠激素：存在关联吗？
Postprandial oxidative stress and gastrointestinal hormones: is there a link?
作者信息
Malinska Hana, Kahleova Hana, Topolcan Ondrej, Vrzalova Jindra, Oliyarnyk Olena, Kazdova Ludmila, Belinova Lenka, Hill Martin, Pelikanova Terezie
机构信息
Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
Faculty Hospital Pilsen, Pilsen, Czech Republic.
出版信息
PLoS One. 2014 Aug 20;9(8):e103565. doi: 10.1371/journal.pone.0103565. eCollection 2014.
BACKGROUND
Abnormal postprandial elevation of plasma glucose and lipids plays an important role in the pathogenesis of diabetes and strongly predicts cardiovascular mortality. In patients suffering from type 2 diabetes (T2D) postprandial state is associated with oxidative stress, cardiovascular risk and, probably, with impairment of both secretion and the effect of gastrointestinal peptides. Evaluating postprandial changes of gastrointestinal hormones together with changes in oxidative stress markers may help to understand the mechanisms behind the postprandial state in diabetes as well as suggest new preventive and therapeutical strategies.
METHODS
A standard meal test has been used for monitoring the postprandial concentrations of gastrointestinal hormones and oxidative stress markers in patients with T2D (n = 50) compared to healthy controls (n = 50). Blood samples were drawn 0, 30, 60, 120 and 180 minutes after the standard meal.
RESULTS
Both basal and postprandial plasma concentrations of glucose and insulin proved to be significantly higher in patients with T2D, whereas plasma concentrations of ghrelin showed significantly lower values during the whole meal test. In comparison with healthy controls, both basal and postprandial concentrations of almost all other gastrointestinal hormones and lipoperoxidation were significantly increased while ascorbic acid, reduced glutathione and superoxide dismutase activity were decreased in patients with T2D. A positive relationship was found between changes in GIP and those of glucose and immunoreactive insulin in diabetic patients (p<0.001 and p<0.001, respectively) and between changes in PYY and those of glucose (p<0.01). There was a positive correlation between changes in GIP and PYY and changes in ascorbic acid in patients with T2D (p<0.05 and p<0.001, respectively).
CONCLUSION/INTERPRETATION: Apart from a positive relationship of postprandial changes in GIP and PYY with changes in ascorbic acid, there was no direct link observed between gastrointestinal hormones and oxidative stress markers in diabetic patients.
TRIAL REGISTRATION
ClinicalTrials.gov NCT01572402.
背景
餐后血糖和血脂异常升高在糖尿病发病机制中起重要作用，并强烈预测心血管死亡率。在2型糖尿病（T2D）患者中，餐后状态与氧化应激、心血管风险相关，可能还与胃肠肽分泌及作用受损有关。评估胃肠激素的餐后变化以及氧化应激标志物的变化，可能有助于理解糖尿病餐后状态背后的机制，并提出新的预防和治疗策略。
方法
采用标准餐试验监测T2D患者（n = 50）与健康对照者（n = 50）餐后胃肠激素和氧化应激标志物的浓度。在标准餐后0、30、60、120和180分钟采集血样。
结果
T2D患者基础和餐后血浆葡萄糖和胰岛素浓度均显著更高，而在整个餐试验期间，胃饥饿素血浆浓度显著更低。与健康对照者相比，T2D患者几乎所有其他胃肠激素的基础和餐后浓度以及脂质过氧化均显著升高，而抗坏血酸、还原型谷胱甘肽和超氧化物歧化酶活性降低。糖尿病患者中，胃抑肽（GIP）变化与葡萄糖和免疫反应性胰岛素变化之间存在正相关（分别为p<0.001和p<0.001），以及肽YY（PYY）变化与葡萄糖变化之间存在正相关（p<0.01）。T2D患者中，GIP和PYY变化与抗坏血酸变化之间存在正相关（分别为p<0.05和p<0.001）。
结论/解读：除了GIP和PYY的餐后变化与抗坏血酸变化呈正相关外，糖尿病患者胃肠激素与氧化应激标志物之间未观察到直接联系。
试验注册
ClinicalTrials.gov NCT01572402
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