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缺血性中风患者氧化应激参数与炎症标志物的相关性

Correlation of Oxidative Stress Parameters and Inflammatory Markers in Ischemic Stroke Patients.

作者信息

Chehaibi Khouloud, Trabelsi Imen, Mahdouani Kacem, Slimane Mohamed Naceur

机构信息

Research Unit: UR 12ES09 Dyslipidemia and Atherogenesis, Faculty of Medicine, Monastir, Tunisia.

Research Unit: UR 12ES09 Dyslipidemia and Atherogenesis, Faculty of Medicine, Monastir, Tunisia.

出版信息

J Stroke Cerebrovasc Dis. 2016 Nov;25(11):2585-2593. doi: 10.1016/j.jstrokecerebrovasdis.2016.06.042. Epub 2016 Jul 26.

Abstract

BACKGROUND

Ischemic stroke (IS) usually initiates inflammation and oxidative stress leading to neuronal death. Diabetes and impaired fasting glucose are associated with incidence of cerebrovascular and cardiovascular diseases.

METHODS

In the present study, we assessed the relationship of fasting glucose with antioxidative parameters (erythrocyte glutathione peroxidase [GPx] and superoxide dismutase [SOD] activities) and inflammatory markers (high-sensitivity C-reactive protein [hs-CRP] and fibrinogen) in IS patients with and without type 2 diabetes mellitus (T2DM). In addition, we determined factors associated with the risk of IS among these patients. Antioxidative, inflammatory, and lipid parameters were measured in 196 patients with IS (117diabetics and 79 nondiabetics).

RESULTS

After adjustment of covariates, multiple logistic regression analysis showed that SOD and GPx significantly decreased the risk of IS among patients with and without T2DM. However, hs-CRP increased the risk of IS. For the diabetic patients, fasting glucose was positively correlated with hs-CRP and fibrinogen and was negatively correlated with GPx and SOD levels. In addition, fasting glucose and hemoglobin A1c or glycosylated hemoglobin (HbA1c) have been shown to increase the risk of IS in diabetic patients.

CONCLUSIONS

These data suggest that the antioxidant activity of plasma may be an important factor that provides protection from IS. hs-CRP concentrations can be used as a clinical screening tool to identify individuals with higher risk of IS. Finally, fasting glucose and HbA1c may also be useful indicators for cerebrovascular risk in diabetic patients that may be mediated by low levels of antioxidative defense markers and high inflammation status.

摘要

背景

缺血性中风(IS)通常引发炎症和氧化应激,导致神经元死亡。糖尿病和空腹血糖受损与脑血管和心血管疾病的发病率相关。

方法

在本研究中,我们评估了患有和未患有2型糖尿病(T2DM)的IS患者中空腹血糖与抗氧化参数(红细胞谷胱甘肽过氧化物酶[GPx]和超氧化物歧化酶[SOD]活性)以及炎症标志物(高敏C反应蛋白[hs-CRP]和纤维蛋白原)之间的关系。此外,我们确定了这些患者中与IS风险相关的因素。对196例IS患者(117例糖尿病患者和79例非糖尿病患者)进行了抗氧化、炎症和血脂参数测量。

结果

在调整协变量后,多因素逻辑回归分析表明,SOD和GPx显著降低了患有和未患有T2DM患者的IS风险。然而,hs-CRP增加了IS风险。对于糖尿病患者,空腹血糖与hs-CRP和纤维蛋白原呈正相关,与GPx和SOD水平呈负相关。此外,空腹血糖和糖化血红蛋白A1c(HbA1c)已被证明会增加糖尿病患者的IS风险。

结论

这些数据表明,血浆的抗氧化活性可能是预防IS的一个重要因素。hs-CRP浓度可作为一种临床筛查工具,用于识别IS风险较高的个体。最后,空腹血糖和HbA1c也可能是糖尿病患者脑血管风险的有用指标,这可能由抗氧化防御标志物水平低和炎症状态高所介导。

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