老年2型糖尿病肾病患者氧化应激与尿单核细胞趋化蛋白-1相关关系

目的通过对老年2型糖尿病不同肾病分期患者血中抗活性氧族(ROS)活性、谷胱甘肽过氧物酶(GSH-PX)及尿单核细胞趋化蛋白-1(MCP-1)的水平测定,观察3项指标的变化趋势及相关关系。方法按年龄将2型糖尿病患者分成老年组及非老年组。并根据24h尿微量白蛋白(UMA)水平继续分组,分别进行抗ROS活性、GSH-PX及尿MCP-1不同肾病分期的组间比较。抗ROS活性、GSH-PX检测采用分光光度计法,尿MCP-1测定采用ELISA法。结果无论老年组、非老年组不同糖尿病肾病分期组间抗ROS活性、GSH-PX均随糖尿病肾病的进展而活性下降,尿MCP-1则呈上升趋势。老年组和非老年组组间3项指标比较没有差异。经Logistic回归分析发现,抗ROS活性、GSH-PX及尿MCP-1分别与24h尿蛋白(r=-0.71;-0.22;0.45)、Ccr(r=-0.33;-0.34;0.47)呈密切相关。结论随老年2型糖尿病肾病程度的加重,抗ROS活性、GSH-PX水平呈下降趋势,使代表肾脏炎症反应的尿MCP-1随尿排出增加,推测ROS介导的炎性反应可能通过肾脏局部MCP-1的产生在老年糖尿病肾病的发生、发展中发挥了作用。

Relationship between Oxidative Stress and Urine Monocyte Chemoattractant Protein-1 in Old Patients with Type 2 Diabetes Mellitus

Objective To observe the changes of anti-ROS, GSH-PX and urine MCP-1 and their relationship in different diabetic nephropathy stages in old patients with type 2 diabetes mellitus. Methods We examined the blood concentration of anti-ROS, GSH-PX and urine MCP-1 in old type 2 diabetic patients and non-old ones. Then they were divided into subgroups by 24 h urine UMA respectively. Anti-ROS and GSH-PX were checked by spectrophotometer. Urine MCP-1 was determined by ELISA. Results In different renal stages, anti-ROS and GSH-PX reduced and urine MCP-1 increased with the development of the renal dysfunction, and no difference showed between old diabetic patients and non-old patients. Logistic regression showed that anti-ROS,GSH-PX and urine MCP-1 were significantly correlated with 24 h urine total protein(r=-0.71;-0.22;0.45)and Ccr (r=-0.39;-0.34;0.47). Conclusions With diabetic renal dysfunction, ROS accumulated, GSH-PX reduced, and excretion of urine MCP-1 increased. So we can assume that ROS via inflammation reaction damaged renal function of the old diabetic patients through the increase of renal MCP-1.