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“氧化应激”——糖尿病管理中的新靶点。

'Oxidative stress'-A new target in the management of diabetes mellitus.

作者信息

Das Ashok K, Kalra Sanjay, Punyani Hitesh, Deshmukh Swapnil, Taur Santosh

机构信息

Professor of Eminence, Department of Medicine and Dean Academics, Mahatma Gandhi Medical College and Institute, and SBV University, Pondicherry, India.

Consultant and Head, Bharti Research Institute of Diabetes and Endocrinology (BRIDE), Kunjpura Road, Karnal, Haryana, India.

出版信息

J Family Med Prim Care. 2023 Nov;12(11):2552-2557. doi: 10.4103/jfmpc.jfmpc_2249_21. Epub 2023 Nov 21.

Abstract

Diabetes mellitus (DM) is a chronic condition that poses a mammoth challenge for the healthcare system in developing as well as developed nations. Diabetes mellitus is associated with damage to the vasculature which leads to microvascular and macrovascular complications. Oxidative stress is a consequence of glucotoxicity and lipotoxicity, which are associated with diabetes. Glucotoxicity and lipotoxicity play a part in the pathogenesis of β-cell dysfunction. The hyperglycemic state in DM leads to oxidative stress which further hampers insulin secretion. In diabetes, the biological antioxidants also get depleted along with a reduction in glutathione (GSH), an increase in the oxidized glutathione (GSSG)/GSH ratio, and a depletion of non-enzymatic antioxidants. This results in the formation of a viscous circle of hyperglycemia leading to increased oxidative stress that further hampers insulin secretion which in turn results in hyperglycemia. Antioxidants are efficacious in reducing diabetic complications. The antioxidants produced biologically fall short, hence external supplements are required. In this review, the authors have discussed the relationship between oxidative stress in DM and the advantages of antioxidant supplements in controlling blood glucose levels and also in deaccelerating the complications related to DM.

摘要

糖尿病(DM)是一种慢性疾病,对发展中国家和发达国家的医疗系统都构成了巨大挑战。糖尿病与血管损伤相关,会导致微血管和大血管并发症。氧化应激是糖毒性和脂毒性的结果,而糖毒性和脂毒性与糖尿病有关。糖毒性和脂毒性在β细胞功能障碍的发病机制中起作用。糖尿病中的高血糖状态会导致氧化应激,进而进一步阻碍胰岛素分泌。在糖尿病中,生物抗氧化剂也会随着谷胱甘肽(GSH)的减少、氧化型谷胱甘肽(GSSG)/GSH比值的增加以及非酶抗氧化剂的消耗而耗尽。这导致形成一个高血糖的恶性循环,导致氧化应激增加,进而进一步阻碍胰岛素分泌,反过来又导致高血糖。抗氧化剂在减少糖尿病并发症方面是有效的。生物产生的抗氧化剂不足,因此需要外部补充剂。在这篇综述中,作者讨论了糖尿病中氧化应激与抗氧化剂补充剂在控制血糖水平以及减缓与糖尿病相关并发症方面的优势之间的关系。

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