血糖波动对糖尿病患者外周血白细胞磷酸己糖旁路代谢及呼吸爆发的影响

目的观察血糖波动对2型糖尿病患者外周白细胞磷酸己糖旁路（HMP）关键酶——葡萄糖-6-磷酸脱氢酶（G6PD）活性、
G6PDmRNA表达及呼吸爆发功能的变化，探讨血糖波动对白细胞呼吸爆发的影响。方法选取45例2型糖尿病患者，通过动态
血糖监测评估其血糖波动情况，同时检测外周血白细胞G6PD活性及G6PDmRNA表达，并通过检测白细胞活性氧（ROS）产量
评价其呼吸爆发功能，研究血糖波动对白细胞HMP旁路代谢及呼吸爆发功能的影响。结果与正常人相比，糖尿病患者外周血
白细胞G6PD活性（F=78.739, P<0.05）及ROS含量明显降低（F=384.962，P<0.05），G6PDmRNA的表达均明显升高（F=269.612，
P<0.01），且与血糖波动幅度密切相关。结论血糖控制不稳可使白细胞内G6PD活性下降、磷酸已糖旁路代谢紊乱，从而导致
其呼吸爆发功能受损。平稳降糖有利于减少糖尿病并感染。

Effects of glucose variation on hexose monophosphate shunt and leucocyte respiratory burst in patients with type 2 diabetes

Objective To investigate the effect of blood glucose instability on respiratory burst of leukocytes in patients with
type 2 diabetes (T2DM). Methods Forty-five patients with T2DM were divided into 3 groups after continuous glucose
monitoring for 72 h with glucose wavy coefficient <1.5 (n=11), between 1.5 and 3.0 (n=19), and >3.0 (n=15). Peripheral blood
neutrophils were isolated from the diabetic patients and normal control subjects for assay of glucose 6-phosphate
dehydrogenase (G6PD) with a spectrophotometric method, detecting G6PD mRNA expression by real-time PCR, and
determining reactive oxygen species level using the fluorescent probe DCFH-DA. Results Compared with the normal control
group, the diabetic patients showed significantly lowered G6PD activity (F=78.739, P<0.05) and ROS level (F=384.962, P<0.05)
but significantly increased G6PD mRNA expression (F=269.612, P<0.01). These changes were significantly correlated with the
blood glucose wavy coefficients. Conclusion The fluctuation of blood glucose in T2DM patients can decrease G6PD activity
and lead to functional decline of the respiratory burst.