非胰岛素依赖型糖尿病体内氧化代谢改变及与高血压的关系

目的 :评价氧化损伤及抗氧化酶活性对非胰岛素依赖型糖尿病即Ⅱ型糖尿病 (NIDDM )及其伴发高血压 (HT)的影响。方法 :采用鲁米诺依赖的中性粒细胞化学发光法 ,对 136例NIDDM患者 (其中 70例不伴有HT ,6 6例伴有HT)及 30例年龄匹配的健康对照者 ,检测其外周血中性粒细胞产生氧自由基 (OFR)的水平。采用化学定量法 ,测定其血浆脂质过氧化终末产物———丙二醛 (MDA)的浓度及抗氧化酶———超氧化物歧化酶 (SOD)、谷胱甘肽过氧化物酶 (GSHPx)的活性。结果 :NIDDM伴发HT组 ,其PMN -CL峰值、积分和吞噬指数均明显高于NIDDM不伴HT组及健康对照组 ;血浆MDA浓度较后两组也明显升高 (P均 <0 .0 1) ;NIDDM组及NIDDM伴发HT组的血浆SOD和GSHPx活性较正常对照组均明显降低 (P均 <0 .0 1) ;但与NIDDM组相比 ,NIDDM伴发HT组的血浆SOD和GSHPx活性其差异无显著性 (P均 >0 .0 5 ) ;PMN -CL峰值与MDA呈明显正相关 (r=0 .7486 ,Y =15 9.8X 132 .2 ,P <0 .0 1,n =6 6 ) ,与SOD活性呈明显负相关 (r =- 0 .6 471,Y =5 .6X 112 7.4,P <0 .0 5 ,n =6 6 )。结论 :NIDDM患者体内已存在着氧化损伤 ,而在NIDDM伴发HT时氧化损伤进一步加重 ,提示氧化损伤对NIDDM患者HT的发生发展可能有着病因学意义

HANGE OF OXIDATION METABOLISM OF NIDDM AND RELATIONSHIP BETWEEN NIDDM AND HYPERTENSION

ObjectivesOxidative stressis believed to play an important role in the development of hypertension associates withdiabetes mellitus in animal models.To test this hypothesis in humans,To evaluate themarkers of polymorphonuclear leukocyte oxygen free radical (OFR) production,lipidperoxidation and defenses against oxidative stress in NIDDM patients with and withouthypertension.MethodsA convenient and senstive method for estimation of neutrophil OFRproduction was assayed by polymorphonuclear leukocyte chemiluminescence (PMN-CL).Theparameters of PMN-CL have been measured,the plasma malondialdehyde(MDA) concentration,andthe plasma activities of superoxide dismutase(SOD) and glulathione peroxidase (GSHPx) in136 NIDDM patients (70 without hypertension and 66 with hypertension) and 30 age-matchedhealthy subjects.ResultsPatients with hypertension showed significantly increased PMN-CLparameters as peak value,integration,and phagocytic index compared to diabetics withouthypertension and healthy controls ,(P<0.01,respectively).And the plasma MDSconcentration,increased in patients with hypertension compared with that in diabeticswithout hypertension and healthy controls,P<0.01.respectively.The PMN-CL peak valuecorrelated best with plasma MDA concentration (r=0.748 6,P<0.01,n=66) and negativelycorrelated with the plasma activity of SOD (r=-0.6471,P<0.05,n=66).ConclusionsThesedata confirm that the oxidative stress exists in NIDDM and suggest that diabetic patientswith hypertension have an increase in this oxidative stress which may have pathogeneticimplications.