Schillern Emmelien E M, Pasch Andreas, Feelisch Martin, Waanders Femke, Hendriks Steven H, Mencke Rik, Harms Geert, Groenier Klaas H, Bilo Henk J G, Hillebrands Jan-Luuk, van Goor Harry, van Dijk Peter R
University of Groningen, University Medical Centre, Department of Pathology and Medical Biology, Groningen, the Netherlands.
University of Bern, Department of Biomedical Research, Bern, Switzerland.
J Clin Transl Endocrinol. 2019 Feb 28;16:100182. doi: 10.1016/j.jcte.2019.100182. eCollection 2019 Jun.
Oxidative stress is a driver in the development of type 2 diabetes (T2DM) complications. As thiols (R-SH) are oxidized by reactive oxygen and sulfur species, circulating concentrations may directly reflect systemic redox status. We hypothesized that high serum R-SH concentrations are a reflection of a favourable redox status and may therefore positively associate with disease status.
R-SH were measured in serum of 943 T2DM outpatients (55% males, 65 years and HbA1c of 6.7% (50 mmol/mol)) with a follow-up period of 1.2 years.
In the highest R-SH tertile patients were younger, more often men, had less microvascular complications, lower HbA1c and were more often treated nutritionally or with oral glucose-lowering drugs. Age- and sex adjusted hazard ratios for developing micro-, macro- or any complication plus death were 0.994, 0.992 and 0.993: even after adjustment for potential confounders. The Harrell's C statistic to predict microvascular complications or any complication plus death was higher in the models with R-SH than in those without R-SH.
Although R-SH concentrations were associated with a favourable disease status, it did not add to the predictive capacity for long-term complications. Based on the current data R-SH seems unsuitable as a prognostic marker in T2DM.
氧化应激是2型糖尿病（T2DM）并发症发生发展的驱动因素。由于硫醇（R-SH）会被活性氧和硫物种氧化，循环浓度可能直接反映全身氧化还原状态。我们假设高血清R-SH浓度反映了良好的氧化还原状态，因此可能与疾病状态呈正相关。
对943例T2DM门诊患者（55%为男性，年龄65岁，糖化血红蛋白为6.7%（50 mmol/mol））的血清进行R-SH检测，随访期为1.2年。
在R-SH最高三分位数组中，患者更年轻，男性更多，微血管并发症更少，糖化血红蛋白更低，且更多接受营养治疗或口服降糖药物治疗。发生微血管、大血管或任何并发症加死亡的年龄和性别调整风险比分别为0.994、0.992和0.993：即使在对潜在混杂因素进行调整后也是如此。在预测微血管并发症或任何并发症加死亡方面，包含R-SH的模型中的Harrell's C统计量高于不包含R-SH的模型。
虽然R-SH浓度与良好的疾病状态相关，但它并未增加对长期并发症的预测能力。基于目前的数据，R-SH似乎不适用于作为T2DM的预后标志物。
