Harran University, School of Medicine, Department of Endocrinology, Sanliurfa, Turkey.
Harran University, School of Medicine, Department of Medical Biochemistry, Sanliurfa, Turkey.
Diabetes Res Clin Pract. 2019 Feb;148:249-253. doi: 10.1016/j.diabres.2019.01.022. Epub 2019 Jan 26.
Thiol/disulphide homeostasis plays a critical role in antioxidant defense, and detoxification in body. Although alteration of thiol/disulfide homeostasis had been shown in patients with diabetes, the thiol/disulfide balance in patients with type 2 diabetes and nephropathy is not yet known.
Twenty-six healthy volunteers (group 1), and 17 normal albuminuric (group 2), 24 middle albuminuric (group 3), 20 severe proteinuric (group 4) patients with type 2 diabetes were included. Proteinuria was tested by measuring microalbumin/creatinine ratio in spot urine. Thiol/disulphide homeostasis concentrations were measured using method developed by Erel et al. RESULTS: Mean blood urea and creatinine levels were found to be significantly higher and GFR level was found to be significantly lower in group 4 than in the other groups. Native thiol levels are significantly lower in groups with diabetes than in healthy group and in groups 3 and 4, compared to group 2. Total thiol level was significantly lower in groups 3 and 4 than group 1 and 2. Disulphide/native thiol and disulfide/total thiol ratios were significantly higher in the groups with diabetes than in group 1 and in the group 4 than in the group 2.
The level of native and total thiols were found to be decreased significantly with the grade of nephropathy in patients with type 2 diabetes and the balance had been disrupted in favor of disulphide. We suggest that deteriorated thiol/disulphide balance may be one of the important factors in the development or progression of diabetes induced nephropathy.
巯基/二硫键稳态在抗氧化防御和体内解毒中起着关键作用。尽管已经在糖尿病患者中显示出巯基/二硫键稳态的改变，但 2 型糖尿病伴肾病患者的巯基/二硫键平衡尚不清楚。
纳入 26 名健康志愿者（第 1 组）、17 名正常白蛋白尿（第 2 组）、24 名中白蛋白尿（第 3 组）、20 名严重蛋白尿（第 4 组）的 2 型糖尿病患者。通过测量尿微量白蛋白/肌酐比值来检测蛋白尿。巯基/二硫键稳态浓度采用 Erel 等人开发的方法进行测量。
第 4 组的平均血尿素和肌酐水平明显高于其他组，肾小球滤过率明显低于其他组。与健康组和第 2 组相比，糖尿病组的内源性巯基水平明显较低，第 3 组和第 4 组的内源性巯基水平明显较低。第 3 组和第 4 组的总巯基水平明显低于第 1 组和第 2 组。糖尿病组的二硫化物/内源性巯基和二硫化物/总巯基比值明显高于第 1 组，第 4 组明显高于第 2 组。
在 2 型糖尿病患者中，随着肾病程度的加重，内源性和总巯基水平明显降低，二硫键的平衡被打破。我们认为，恶化的巯基/二硫键平衡可能是糖尿病肾病发展或进展的重要因素之一。
