α-硫辛酸与维生素C对2型糖尿病患者氧化应激水平及炎症因子影响的比较研究
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摘要
目的1.观察短期胰岛素强化降糖治疗后,2型糖尿病患者血清总SOD活力、MDA含量和ICAM-1水平、hsCRP水平的变化。2.探讨α-硫辛酸、维生素C对强化降糖治疗的2型糖尿病患者氧化应激水平及内皮细胞功能的影响。
方法2型糖尿病患者接受治疗前检测血清总SOD活性、MDA含量及ICAM-1水平、hsCRP水平,予以7天胰岛素强化降糖治疗后对上述指标进行检测,并分为三组:⑴α-硫辛酸组,继续胰岛素强化降糖治疗并加予α-硫辛酸干预治疗7天后复测上述指标;⑵维生素C组,继续胰岛素强化降糖治疗并加予维生素C干预治疗7天后复测上述指标;⑶对照组,继续胰岛素强化降糖治疗7天后复测上述指标。采用分光光度法检测并计算出总SOD活性、MDA含量;酶联免疫吸附法测定ICAM-1水平、hsCRP水平。
结果1.α-硫辛酸组、维生素C组接受胰岛素强化降糖治疗前,血清总SOD活性、MDA含量及ICAM-1水平、hsCRP水平无显著性差异。2. 33例患者接受胰岛素强化降糖治疗7d后,血清总SOD活性明显升高(P<0.01),MDA含量明显降低(P<0.01),ICAM-1水平、hsCRP水平无显著性变化。3.胰岛素强化降糖治疗7d后,α-硫辛酸组加予α-硫辛酸干预7d。比较α-硫辛酸0d、α-硫辛酸7d血清总SOD活性、MDA含量及ICAM-1水平、hsCRP水平,血清总SOD活性明显升高(P<0.05),MDA含量明显降低(P<0.01),ICAM-1水平、hsCRP水平无显著性变化。4.胰岛素强化降糖治疗7d后,维生素C组加予维生素C干预7d。比较维生素C0d、维生素C7d血清总SOD活性、MDA含量及ICAM-1水平、hsCRP水平,血清总SOD活性明显升高(P<0.05),MDA含量明显降低(P<0.05),ICAM-1水平、hsCRP水平无显著性变化。5.两组患者分别经过α-硫辛酸或维生素C治疗7d后,血清总SOD活性、MDA含量及ICAM-1水平、hsCRP水平的变化无显著性差异。
结论1、强化降糖治疗,纠正高血糖状态可以使2型糖尿病患者血清总SOD活性升高及MDA含量降低;2、强化降糖加用α-硫辛酸7d与加用维生素C 7d比较,总SOD活性及MDA含量相当,α-硫辛酸短期抗氧化效果与维生素C相当;3、强化降糖治疗可以减轻氧化应激,但不能立即降低机体ICAM-1及hsCRP水平,改善内皮细胞功能;4、短期分别予以α-硫辛酸及维生素C治疗,存在一定抗氧化能力,但不能同步降低机体ICAM-1及hsCRP水平,即不能改善内皮细胞功能。
Objective 1. Observe total SOD activity, MDA content and the level of ICAM-1, hsCRP level changes in patients with type 2 diabetes after the short-term intensive insulin antidiabetic therapy. 2.Investigate the influence ofα-lipoic acid and vitamin C on oxidative stress and endothelial cell function in patients with type 2 diabetes after the intensive insulin antidiabetic therapy.
Methods Serum total SOD activity, MDA content and the level of ICAM-1, hsCRP in patients of type 2 diabetic were tested before and after the treatment of 7 days intensive insulin antidiabetic treatment,and the patients were divided into three groups:⑴α-lipoic acid group, continuing intensive insulin antidiabetic treatment and addingα-lipoic acid treatment for 7 days before the targets were tested;⑵vitamin C group, continuing intensive insulin therapy and adding vitamin C treatment for 7 days before the targets were tested;⑶the control group, continuing intensive insulin antidiabetic treatment for 7 days before the targets were tested. Spectrophotometry was used to detect and calculate the total SOD activity, MDA content; ELISA was used to detect levels of ICAM-1, hsCRP levels.
Results 1. Serum total SOD activity, MDA content and the level of ICAM-1, hsCRP levels were not significantly different inα-lipoic acid, vitamin C group before receiving intensive insulin antidiabetic treatment. 2. Serum SOD activity was significantly increased (P <0.01) and MDA significantly decreased (P <0.01) in 33 cases of patients receiving 7days intensive insulin therapy, and ICAM-1 levels, hsCRP levels were not significantly changed. 3. Comparison ofα-lipoic acid 0d,α-lipoic acid 7d serum total SOD activity, MDA content and the level of ICAM-1, hsCRP levels, total serum SOD activity was significantly increased (P <0.05), MDA significantly decreased (P <0.01) , ICAM-1 levels, hsCRP levels were not significantly changed inα-lipoic acid group which was added to theα-lipoic acid for 7days after 7days intensive insulin therapy. 4. Comparison of vitamin C 0d, vitamin C 7d serum total SOD activity, MDA content and the level of ICAM-1, hsCRP levels, total serum SOD activity was significantly increased (P <0.05), MDA significantly decreased (P <0.05), ICAM-1 levels hsCRP levels were not significantly changed in vitamin C group which was added to the vitamin C for 7days after 7days intensive insulin therapy. 5. Serum total SOD activity, MDA content and the level of ICAM-1, hsCRP levels have no significant difference in two groups treated withα-lipoic acid or vitamin C 7d.
Conclusion 1, Correction of high blood sugar state with intensive insulin therapy can elevate serum total SOD activity and decrease MDA content in type 2 diabetic patients; 2, Compared with the total SOD activity and MDA content, no significant difference in intensive insulin therapy plusα-lipoic acid 7d or vitamin C 7d , antioxidant effect ofα-lipoic acid in short-term equal to vitamin C; 3, Intensive insulin therapy can reduce oxidative stress, but can not immediately reduce the level of ICAM-1 and hsCRP, improve endothelial function in the body; 4, Short-termα-lipoic acid or vitamin C treatment has a certain antioxidant capacity, but can not simultaneously reduce the body's levels of ICAM-1 and hsCRP, which does not improve endothelial function.
方法2型糖尿病患者接受治疗前检测血清总SOD活性、MDA含量及ICAM-1水平、hsCRP水平,予以7天胰岛素强化降糖治疗后对上述指标进行检测,并分为三组:⑴α-硫辛酸组,继续胰岛素强化降糖治疗并加予α-硫辛酸干预治疗7天后复测上述指标;⑵维生素C组,继续胰岛素强化降糖治疗并加予维生素C干预治疗7天后复测上述指标;⑶对照组,继续胰岛素强化降糖治疗7天后复测上述指标。采用分光光度法检测并计算出总SOD活性、MDA含量;酶联免疫吸附法测定ICAM-1水平、hsCRP水平。
结果1.α-硫辛酸组、维生素C组接受胰岛素强化降糖治疗前,血清总SOD活性、MDA含量及ICAM-1水平、hsCRP水平无显著性差异。2. 33例患者接受胰岛素强化降糖治疗7d后,血清总SOD活性明显升高(P<0.01),MDA含量明显降低(P<0.01),ICAM-1水平、hsCRP水平无显著性变化。3.胰岛素强化降糖治疗7d后,α-硫辛酸组加予α-硫辛酸干预7d。比较α-硫辛酸0d、α-硫辛酸7d血清总SOD活性、MDA含量及ICAM-1水平、hsCRP水平,血清总SOD活性明显升高(P<0.05),MDA含量明显降低(P<0.01),ICAM-1水平、hsCRP水平无显著性变化。4.胰岛素强化降糖治疗7d后,维生素C组加予维生素C干预7d。比较维生素C0d、维生素C7d血清总SOD活性、MDA含量及ICAM-1水平、hsCRP水平,血清总SOD活性明显升高(P<0.05),MDA含量明显降低(P<0.05),ICAM-1水平、hsCRP水平无显著性变化。5.两组患者分别经过α-硫辛酸或维生素C治疗7d后,血清总SOD活性、MDA含量及ICAM-1水平、hsCRP水平的变化无显著性差异。
结论1、强化降糖治疗,纠正高血糖状态可以使2型糖尿病患者血清总SOD活性升高及MDA含量降低;2、强化降糖加用α-硫辛酸7d与加用维生素C 7d比较,总SOD活性及MDA含量相当,α-硫辛酸短期抗氧化效果与维生素C相当;3、强化降糖治疗可以减轻氧化应激,但不能立即降低机体ICAM-1及hsCRP水平,改善内皮细胞功能;4、短期分别予以α-硫辛酸及维生素C治疗,存在一定抗氧化能力,但不能同步降低机体ICAM-1及hsCRP水平,即不能改善内皮细胞功能。
Objective 1. Observe total SOD activity, MDA content and the level of ICAM-1, hsCRP level changes in patients with type 2 diabetes after the short-term intensive insulin antidiabetic therapy. 2.Investigate the influence ofα-lipoic acid and vitamin C on oxidative stress and endothelial cell function in patients with type 2 diabetes after the intensive insulin antidiabetic therapy.
Methods Serum total SOD activity, MDA content and the level of ICAM-1, hsCRP in patients of type 2 diabetic were tested before and after the treatment of 7 days intensive insulin antidiabetic treatment,and the patients were divided into three groups:⑴α-lipoic acid group, continuing intensive insulin antidiabetic treatment and addingα-lipoic acid treatment for 7 days before the targets were tested;⑵vitamin C group, continuing intensive insulin therapy and adding vitamin C treatment for 7 days before the targets were tested;⑶the control group, continuing intensive insulin antidiabetic treatment for 7 days before the targets were tested. Spectrophotometry was used to detect and calculate the total SOD activity, MDA content; ELISA was used to detect levels of ICAM-1, hsCRP levels.
Results 1. Serum total SOD activity, MDA content and the level of ICAM-1, hsCRP levels were not significantly different inα-lipoic acid, vitamin C group before receiving intensive insulin antidiabetic treatment. 2. Serum SOD activity was significantly increased (P <0.01) and MDA significantly decreased (P <0.01) in 33 cases of patients receiving 7days intensive insulin therapy, and ICAM-1 levels, hsCRP levels were not significantly changed. 3. Comparison ofα-lipoic acid 0d,α-lipoic acid 7d serum total SOD activity, MDA content and the level of ICAM-1, hsCRP levels, total serum SOD activity was significantly increased (P <0.05), MDA significantly decreased (P <0.01) , ICAM-1 levels, hsCRP levels were not significantly changed inα-lipoic acid group which was added to theα-lipoic acid for 7days after 7days intensive insulin therapy. 4. Comparison of vitamin C 0d, vitamin C 7d serum total SOD activity, MDA content and the level of ICAM-1, hsCRP levels, total serum SOD activity was significantly increased (P <0.05), MDA significantly decreased (P <0.05), ICAM-1 levels hsCRP levels were not significantly changed in vitamin C group which was added to the vitamin C for 7days after 7days intensive insulin therapy. 5. Serum total SOD activity, MDA content and the level of ICAM-1, hsCRP levels have no significant difference in two groups treated withα-lipoic acid or vitamin C 7d.
Conclusion 1, Correction of high blood sugar state with intensive insulin therapy can elevate serum total SOD activity and decrease MDA content in type 2 diabetic patients; 2, Compared with the total SOD activity and MDA content, no significant difference in intensive insulin therapy plusα-lipoic acid 7d or vitamin C 7d , antioxidant effect ofα-lipoic acid in short-term equal to vitamin C; 3, Intensive insulin therapy can reduce oxidative stress, but can not immediately reduce the level of ICAM-1 and hsCRP, improve endothelial function in the body; 4, Short-termα-lipoic acid or vitamin C treatment has a certain antioxidant capacity, but can not simultaneously reduce the body's levels of ICAM-1 and hsCRP, which does not improve endothelial function.
引文
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2. Yang W,et al. Prevalence of Diabetes among Men and Women in China. N Engl J Med 2010;362(12):1090-101.
3. Berry C, Tardif JC, Bourassa MG, et al. Coronary heart disease in patients with diabetes.JACC 2007;49(6):643-56.
4. Buse JB, Ginsberg HN, Bakris GL, et al. Primary prevention of cardiovascular diseases in people with diabetes mellitus: a scientific statement from the American Heart Association and the American Diabetes Association. Diabetes Care. 2007;30(1):162-72.
5. Preventing and managing diabetic complications in elderly patients. Cleve Clin J Med.2008; 75(2):153-8.
6. Insull W Jr. The pathology of atherosclerosis: plaque development and plaque response to medical treatment.Am J Med .2009;122:S3-S14.
7. Quinones MJ, Nicholas SB, Lyon CJ.Insulin resistance and the endothelium[J].Curr Diab Rep 2005;5(4):246-253.
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