Departamento de Medicina, Divisão de Endocrinologia, Centro de Diabetes da Universidade Federal de São Paulo, São Paulo, SP, Brasil,
Departamento de Medicina, Divisão de Endocrinologia, Centro de Diabetes da Universidade Federal de São Paulo, São Paulo, SP, Brasil.
Arch Endocrinol Metab. 2021 Oct 29;65(5):570-578. doi: 10.20945/2359-3997000000338. Epub 2021 Mar 19.
The purpose of this study was to investigate the heterogeneity of the association between glycemic variability and oxidative stress markers in T1DM patients under daily life insulin treatment.
We studied, in a cross-sectional analysis, 76 T1DM patients without clinical chronic diabetes complications and 22 healthy individuals. Were evaluated the short-term glycemic variability (STGV), long-term glycemic variability (LTGV), oxidative stress markers [8-isoprostaglandin-F2α (Ur-8-iso-PGF2α), nitric oxide (NO), thiobarbituric acid reactive substances (TBARS) and erythrocytes reduced/oxidized glutathione (GSH/GSSG)] and biochemical dosages (glycaemia, HbA1c, lipidogram, albuminuria).
Plasmatic NO was positively associated with LTGV (last year average of HbA1c) (8.7 ± 1.6% or 71 ± 18 mmol) (rS: 0.278; p: 0.042). Plasmatic TBARS, erythrocytes GSH/GSSH and Ur-8-iso-PGF-2α didn't show correlation with glycemic variability. GSH/GSSG was inversely correlated with LDL-cholesterol (rS: - 0.417; p: 0.047) and triglycerides (rS: -0.521; p: 0.013). Albuminuria was positive correlated with age (rS: 0.340; p: 0.002), plasmatic NO (rS: 0.267; p 0.049) and TBARS (rS: 0.327; p: 0.015).
In daily life insulin treatment, young T1DM patients have higher plasmatic NO than healthy subjects. However, the correlation between glycemic variability and oxidative stress markers is heterogeneous. Lipid profile and albuminuria are associated with different oxidative stress markers. These data collaborate to explain the controversial results in this issue.
本研究旨在探讨日常胰岛素治疗下 T1DM 患者血糖变异性与氧化应激标志物之间的相关性差异。
我们进行了一项横断面分析，共纳入 76 例无临床慢性糖尿病并发症的 T1DM 患者和 22 名健康对照者。评估了短期血糖变异性（STGV）、长期血糖变异性（LTGV）、氧化应激标志物[8-异前列腺素 F2α（尿 8-异前列腺素 F2α）、一氧化氮（NO）、硫代巴比妥酸反应物质（TBARS）和红细胞还原/氧化型谷胱甘肽（GSH/GSSG）]和生化指标（血糖、HbA1c、血脂谱、白蛋白尿）。
血浆 NO 与 LTGV（HbA1c 去年平均值）呈正相关（8.7±1.6%或 71±18mmol）（rS：0.278，p：0.042）。血浆 TBARS、红细胞 GSH/GSSH 和尿 8-异前列腺素 F2α 与血糖变异性无相关性。GSH/GSSG 与 LDL-胆固醇呈负相关（rS：-0.417，p：0.047）和三酰甘油（rS：-0.521，p：0.013）。白蛋白尿与年龄呈正相关（rS：0.340，p：0.002），与血浆 NO 呈正相关（rS：0.267，p：0.049）和 TBARS 呈正相关（rS：0.327，p：0.015）。
在日常胰岛素治疗下，年轻的 T1DM 患者的血浆 NO 水平高于健康对照者。然而，血糖变异性与氧化应激标志物之间的相关性存在差异。血脂谱和白蛋白尿与不同的氧化应激标志物相关。这些数据有助于解释该领域存在的争议结果。
