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胰岛素泵治疗对糖尿病肾病患者氧化应激的影响。

The impact of insulin pump therapy to oxidative stress in patients with diabetic nephropathy.

机构信息

Department of Endocrinology, PLA Army General Hospital, Beijing, China.

China National Institute of Standardization, Beijing, China.

出版信息

Eur J Med Res. 2018 Feb 12;23(1):7. doi: 10.1186/s40001-018-0304-2.

Abstract

BACKGROUND

The oxidative stress resulting from increased production of ROS plays a crucial role in the development of diabetic complications. We aim to explore the relationships between oxidative stress, diabetic nephropathy (DN) and short-term insulin pump intensive therapy (insulin therapy).

METHODS

Levels of 8-hydroxy-deoxyguanosine (8-OHdG), 3-nitrotyrosine (3-NT), glutathione (GSH), superoxide dismutase (SOD) and Interleukin-6 (IL-6) were estimated before and after 2 weeks of insulin therapy in normal group (NC) and type 2 diabetic (DM) with normal albuminuria (NA), microalbuminuria (MA) and clinical albuminuria (CA).

RESULTS

In DM group, levels of 8-OHdG and 3-NT were higher than those in NC group (P < 0.05); GSH and SOD were lower (P < 0.05). And their levels changed with urine albumin-creatinine ratio (P < 0.05). After insulin therapy, these derangements were significantly ameliorated and the changes in NA and MA groups were more significant than CA group (P < 0.05). Correlation analysis showed glycated hemoglobin, the course of disease, the HOME-IR and fasting plasma glucose were positively correlated with 8-OHdG and 3-NT, but negatively correlated with GSH and SOD.

CONCLUSIONS

The oxidative stress gradually increased with the magnitude of DN, and insulin pump intensive therapy can significantly ameliorate the derangements in the early stage of DN. Trial registration NCT03174821.

摘要

背景

由于 ROS 产生增加导致的氧化应激在糖尿病并发症的发展中起关键作用。我们旨在探讨氧化应激、糖尿病肾病 (DN) 和短期胰岛素泵强化治疗 (胰岛素治疗) 之间的关系。

方法

在正常组 (NC) 和 2 型糖尿病伴正常白蛋白尿 (NA)、微量白蛋白尿 (MA) 和临床白蛋白尿 (CA) 的 DM 患者中,分别在胰岛素治疗前和治疗后 2 周测定 8-羟基脱氧鸟苷 (8-OHdG)、3-硝基酪氨酸 (3-NT)、谷胱甘肽 (GSH)、超氧化物歧化酶 (SOD) 和白细胞介素-6 (IL-6) 的水平。

结果

在 DM 组中,8-OHdG 和 3-NT 的水平高于 NC 组 (P < 0.05);GSH 和 SOD 水平较低 (P < 0.05)。它们的水平随尿白蛋白肌酐比而变化 (P < 0.05)。胰岛素治疗后,这些异常得到明显改善,且在 NA 和 MA 组的变化比 CA 组更为显著 (P < 0.05)。相关性分析表明,糖化血红蛋白、病程、HOME-IR 和空腹血糖与 8-OHdG 和 3-NT 呈正相关,与 GSH 和 SOD 呈负相关。

结论

氧化应激随着 DN 的严重程度逐渐增加,胰岛素泵强化治疗可显著改善 DN 早期的异常。临床试验注册号 NCT03174821。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/070f/5809915/83025cea6247/40001_2018_304_Fig1_HTML.jpg

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