Centre for Diabetes, Endocrinology and Metabolism, Department of Endocrinology, University College of Medical Sciences, University of Delhi, Delhi, India.
Department of Psychiatry, Institute of Human Behaviour and Allied Sciences, Delhi, India.
Diabetes Metab Res Rev. 2019 Jul;35(5):e3147. doi: 10.1002/dmrr.3147. Epub 2019 Mar 25.
Chronic stress is associated with increased risk of type 2 diabetes. Oxidative stress and inflammation are potential mediators of this risk. This study was conducted to investigate the association of oxidative stress and inflammatory markers with chronic stress and newly diagnosed type 2 diabetes.
Oxidative stress/antioxidant status (malondialdehyde [MDA], reduce glutathione [GSH], glutathione reductase [GR], glutathione peroxidase [GPx], catalase [CAT], superoxide dismutase [SOD]), inflammatory markers (highly sensitive C-reactive protein [hsCRP], adiponectin, leptin), chronic stress levels as assessed by stress scales-presumptive stressful life events scale (PSLES), perceived stress scale (PSS), sense of coherence (SOC) and stress biomarker-salivary cortisol in 125 subjects with newly detected diabetes mellitus (NDDM) were compared with an equal number of age and sex matched subjects with normal glucose tolerance (NGT).
NDDM subjects as compared with NGT had significantly increased MDA (P < 0.001), hsCRP (P < 0.001), and leptin (P = 0.014) levels and increased GR (P = 0.043) and SOD (P < 0.001) activity along with decreased GSH (P < 0.001) and adiponectin (P < 0.001) levels. They also had significantly higher PSLES-LT and PSS and lower SOC scores along with elevated levels of 10:00 pm salivary cortisol and post dexamethasone salivary cortisol as compared with NGT. In stepwise logistic regression analysis, variables GSH (OR: 0.805), SOD (OR: 1.004), and adiponectin (OR: 0.771) along with PSLES-LT (OR: 1.007), PSS (OR: 1.147), SOC (OR: 0.667), salivary cortisol 10:00 pm (OR: 1.382), WC (OR: 1.087), and HOMA-IR (OR: 2.721) emerged as significant predictors of NDDM.
The findings of this study indicate that chronic psychological stress and stress responses are associated significantly with inflammation and oxidative stress, which could act as mediating stress related risk factors for type 2 diabetes.
慢性应激与 2 型糖尿病风险增加有关。氧化应激和炎症是这种风险的潜在介质。本研究旨在探讨氧化应激和炎症标志物与慢性应激和新诊断的 2 型糖尿病之间的关系。
对 125 例新诊断的糖尿病患者（NDDM）和 125 例糖耐量正常的年龄和性别匹配的患者（NGT）进行氧化应激/抗氧化状态（丙二醛[MDA]、还原型谷胱甘肽[GSH]、谷胱甘肽还原酶[GR]、谷胱甘肽过氧化物酶[GPx]、过氧化氢酶[CAT]、超氧化物歧化酶[SOD]）、炎症标志物（高敏 C 反应蛋白[hsCRP]、脂联素、瘦素）、应激量表评估的慢性应激水平（假定应激生活事件量表[PSLES]、感知应激量表[PSS]、应对能力[SOC]）和唾液皮质醇进行比较。
与 NGT 相比，NDDM 患者的 MDA（P<0.001）、hsCRP（P<0.001）和瘦素（P=0.014）水平显著升高，GR（P=0.043）和 SOD（P<0.001）活性升高，GSH（P<0.001）和脂联素（P<0.001）水平降低。与 NGT 相比，他们的 PSLES-LT 和 PSS 评分也明显更高，SOC 评分更低，晚上 10 点唾液皮质醇和地塞米松后唾液皮质醇水平升高。在逐步逻辑回归分析中，变量 GSH（OR：0.805）、SOD（OR：1.004）和脂联素（OR：0.771）以及 PSLES-LT（OR：1.007）、PSS（OR：1.147）、SOC（OR：0.667）、晚上 10 点唾液皮质醇（OR：1.382）、WC（OR：1.087）和 HOMA-IR（OR：2.721）被确定为 NDDM 的显著预测因子。
本研究结果表明，慢性心理应激和应激反应与炎症和氧化应激显著相关，这可能是 2 型糖尿病相关风险因素的中介应激因素。
