血清晚期氧化蛋白产物与2型糖尿病患者动脉粥样硬化的关系

目的 探讨血清晚期氧化蛋白产物与2型糖尿病患者动脉粥样硬化性大血管并发症的关系.方法选择90例2型糖尿病患者和60例健康对照者,用酶联免疫吸附法及分光光度法分别检测血清基质细胞衍生因子1α生及晚期氧化蛋白产物水平,采用高分辨超声测定大动脉内膜中膜厚度.结果 2型糖尿病患者血清晚期氧化蛋白产物和基质细胞衍生因子1α水平明显高于健康对照者(P<0.05或P<0.01),2型糖尿病患者高晚期氧化蛋白产物组基质细胞衍生因子1α、空腹血糖、糖化血红蛋白及血清甘油三酯水平和体质指数与正常晚期氧化蛋白产物组比较显著升高(P<0.05),2型糖尿病患者中动脉粥样硬化组晚期氧化蛋白产物及基质细胞衍生因子1α水平明显高于非动脉粥样硬化组(P<0.01或P<0.05).单因素相关分析显示,血清晚期氧化蛋白产物水平与基质细胞衍生因子1α呈正相关(r=0.295,P=0.03),与空腹血糖、糖化血红蛋白、甘油三酯及体质指数呈正相关(r=0.286,P=0.03;r=0.310,P=0.01;r=0.461,P=0.001;r=0.257,P=0.04).结论 2型糖尿病患者蛋白氧化损伤增强,血清晚期氧化蛋白产物增加促进血管内皮细胞基质细胞衍生因子1α表达,晚期氧化蛋白产物增加可能与2型糖尿病动脉粥样硬化相关.

Relationship Between Serum Advanced Oxidation Protein Products and Atherosclerosis in Patients with Type 2 Diabetes Mellitus

Aim To investigate the relationgship between serum advanced oxidation protein products (AOPP) and atherosclerosis in patients with type 2 diabetes mellitus (T2DM). Methods 90 T2DM patients and 60 healthy controls were enrolled. Serum levels of stromal cell-derived factor-1α(SDF-1α) and AOPP were measured by ELISA and spectrophotometry method separafly. Carotid, femoral and common iliac artery intima-media thickness (IMT) were deter-mined with non-invasive high-rosolution B-mode ultrasonography. Results Both serum AOPP and SDF-1α levels were significantly higher in T2DM group as compared with those of heathy controls(80.32±12.65 μmol/L vs 41.80±17.09 μmol/L, P < 0.01; 2652.05±362.07 μg/L vs 2160.37±424.79 μg/L, P < 0.05). Using the mean + 2SD of AOPP concentration as cut-off ponit, T2DM with AOPP more than or equal to 92.97 μmol/L were defined as high AOPP group, while less than 92.97 μmol/L as normal AOPP group. Of all the patients with T2DM higher serum SDF1α levels were found in high AOPP group than those of normal AOPP group (2813.04±330.25 μmol/L vs 2501.73±383.02 μmol/L, P <0.05). Both SDF-1α and AOPP levels were significantly increased in the atheroselerosis (As) group than those of non-As group (2843.93±355.28 μg/L vs 2507.88±360.62 μg/L, P < 0.05; 89.69±12.58 μmol/L vs 75.10±13.09 μmol/L, P <0.01) in the patients with T2DM. As was defined that carotid or femoral or common iliae artery IMT was more than 1 mm or there was a plaque on the vessal wall according to the ultrasonography. Serum levels of AOPP were correlated positively with serum SDF-1α1(r=0. 295, P=0.03). Conclusions Protein oxidation damages were in-creased in T2DM, increased levels of AOPP contribute to the increased expression of SDF-1α on vascular endothelial cells,increased AOPP may be associated with accelerated atherosclerosis in T2DM.