不同剂量α-硫辛酸对2型糖尿病患者尿足细胞标志蛋白及血管内皮生长因子的影响

目的:探讨不同剂量α-硫辛酸(ALA)对2型糖尿病(T2DM)患者尿足细胞标志蛋白(PCX)、血管内皮生长因子(VEGF)及尿白蛋白(UALB)的影响。方法:92例T2DM患者分为常规治疗组(DM组32例)、ALA治疗组[DM 300 mg(30例)及DM 600 mg(30例),分别给予ALA 300 mg及ALA 600 mg静脉滴注,每日一次)。另选34例正常对照者(NC组)。分别于0周及2周测定尿PCX、血VEGF、尿肌酐(Ucr)及UALB。结果:DM 300 mg组及DM 600 mg组治疗2周后VEGF、尿PCX肌酐比(UPCR)、尿白蛋白肌酐比(UACR)低于DM组(P<0.05或P<0.01),DM 600 mg组VEGF、UPCR、UACR低于DM 300 mg组(P均<0.05)。结论:ALA可通过抗氧化应激减少尿PCX的排泄,降低血VEGF,减轻足细胞的损伤和凋亡,并呈一定的剂量依赖性。

Effects of different doses of alpha-lipoic acid on urinary podocalyxin and vascular endothelial growth factor in patients with type 2 diabetes mellitus

OBJECTIVE To investigate effects of different doses of alpha-lipoic acid on urinary podocalyxin (PCX),vascular endothelial growth factors (VEGF) and urinary albumin (UALB) in patients with type 2 diabetes mellitus. METHODS Totally 92 patients with type 2 diabetes mellitus were randomly divided into three groups:conventional treatment group (DM group,n=32),alpha-lipoic acid (ALA) 300 mg treatment group (DM 300 mg,n=30),and ALA 600 mg treatment group (DM 600 mg,n=30).All patients in three groups were treated with dietary control and hypoglycemic drugs.Patients in treatment group were given ALA 300 mg·d^-1 or 600 mg·d^-1 by intravenous infusion for 2 weeks based on initial therapy.Normal control group was also designed (NC,n=34).Levels of PCX,urinary creatinine (Ucr),serum VEGF and UALB were determined at baseline and 2 weeks after treatment. RESULTS Two weeks later,compared with DM group,levels of serum VEGF,urinary podocalyxin-to-creatinine ratio (UPCR),and urinary albumin-to-creatinine ratio (UACR) were decreased after alpha-lipoic acid treatment in DM 300 mg group and DM 600 mg group (P<0.05 or P<0.01).Levels of serum VEGF,UPCR and UACR in DM 600 mg group were lower than in DM 300 mg group (P<0.05). CONCLUSION ALA can reduce urinary PCX excretion,podocyte injury,apoptosis,and decrease serum VEGF by lowering oxidative stress.