Schöttker Ben, Xuan Yang, Gào Xīn, Anusruti Ankita, Brenner Hermann
Division of Clinical Epidemiology and Ageing Research, German Cancer Research Center, Heidelberg, Germany
Network Aging Research, University of Heidelberg, Heidelberg, Germany.
Diabetes Care. 2020 Jan;43(1):130-136. doi: 10.2337/dc19-1379. Epub 2019 Oct 25.
Oxidative stress is believed to play an important role in the pathophysiology of type 2 diabetes, but the few cohort studies that have assessed the association of oxidative stress biomarkers with type 2 diabetes incidence were small and reported inconclusive results.
We examined the associations of urinary oxidized guanine/guanosine (OxGua) levels (a biomarker of DNA/RNA oxidation) and urinary 8-isoprostane levels (a biomarker of lipid peroxidation) with type 2 diabetes incidence in 7,828 individuals initially without diabetes from a population-based German cohort study with 14 years of follow-up. Hazard ratios (HRs) (95% CIs) per 1 SD were obtained using multivariable-adjusted Cox proportional hazards regression models.
In the total population, weak but statistically significant associations with type 2 diabetes incidence were observed for OxGua levels (HR [95% CI] per 1 SD 1.05 [1.01; 1.09]) and 8-isoprostane levels (1.04 [1.00; 1.09]). Stratified analyses showed that associations of both biomarkers with type 2 diabetes incidence were absent in the youngest age-group (50-59 years) and strongest in the oldest age-group (65-75 years) of the cohort, with HR of OxGua levels 1.14 (1.05; 1.23) per 1 SD and of 8-isoprostane levels 1.22 (1.02; 1.45) per 1 SD.
These results from a large cohort study support suggestions that an imbalanced redox system contributes to the development of type 2 diabetes but suggest that this association becomes clinically apparent at older ages only, possibly as a result of reduced cellular repair capacity.
氧化应激被认为在2型糖尿病的病理生理学中起重要作用,但少数评估氧化应激生物标志物与2型糖尿病发病率之间关联的队列研究规模较小,且结果尚无定论。
我们在一项基于人群的德国队列研究中,对7828名最初无糖尿病的个体进行了14年随访,研究尿氧化鸟嘌呤/鸟苷(OxGua)水平(DNA/RNA氧化的生物标志物)和尿8-异前列腺素水平(脂质过氧化的生物标志物)与2型糖尿病发病率之间的关联。使用多变量调整的Cox比例风险回归模型获得每1个标准差的风险比(HRs)(95%置信区间)。
在总体人群中,观察到OxGua水平(每1个标准差的HR [95%置信区间]为1.05 [1.01; 1.09])和8-异前列腺素水平(1.04 [1.00; 1.09])与2型糖尿病发病率存在微弱但具有统计学意义的关联。分层分析显示,在该队列最年轻的年龄组(50 - 59岁)中,这两种生物标志物与2型糖尿病发病率均无关联,而在最年长的年龄组(65 - 75岁)中关联最强,OxGua水平每1个标准差的HR为1.14(1.05; 1.23),8-异前列腺素水平每1个标准差的HR为1.22(x1.02; 1.45)。
这项大型队列研究的结果支持了氧化还原系统失衡促成2型糖尿病发生发展的观点,但表明这种关联仅在老年时才在临床上显现,可能是由于细胞修复能力下降所致。