·胰岛素抵抗及其相关疾病·

　　【摘要】目的 探讨氧化应激与2型糖尿病的关系以及对胰岛素抵抗、胰岛素β细胞的影响因素研究。方法 对FPG ≥ 10 mmo l/L,未使用过口服降糖药物或胰岛素治疗的初诊 T2DM患者60例作为试验组，门诊查体的健康人60例作为对照组，分别于清晨空腹抽血测FPG、餐后2小时血糖( 2hPG)、糖化血清白蛋白( GA)、甘油三酯( TG)、低密度脂蛋白胆固醇(low density lipoprotein cholesterin LDL)、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶( GSH-Px)、丙二醛(malonaldehyde MDA)水平，计算胰岛素抵抗指数 (HOMA- IR )及胰岛素分泌指数(HOMA - β)。结果 (1)2型糖尿病患者FPG、2hPG、GA、TG、LDL均比健康对照组明显增高，差异均有统计学意义(P<0.01)。(2)2型糖尿病患者抗氧化酶SOD、GSH-Px以及胰岛素分泌指数(HOMA - β)均比健康对照组低，氧化应激指标MDA及胰岛素抵抗指数(HOMA- IR)比健康对照组高，差异均有统计学意义(P<0.01)。(3)Pearson相关分析表明，2型糖尿病患者FPG与MDA水平呈正相关(r= 0.944, P<0.01)，GA与MDA水平呈正相关(r=0.392, P<0.05), log-IR与FPG、GA、MDA水平呈正相关(P<0.01)，log-β与FPG、2hPG、MDA水平呈负相关(P<0.01),差异均有统计学意义。(4) logistic回归分析结果显示：SOD、MDA是2型糖尿病的影响因素，差异均有统计学意义(P<0.05)。结论T2DM 患者存在明显的糖脂代谢紊乱以及氧化应激，氧化应激对胰岛β细胞分泌功能及胰岛素抵抗有显著影响。

　　【关键词】糖尿病, 2型;血糖;氧化应激;HOMA-IR;HOMA–β;

Observation on the relationship between oxidative stress and T2DM ZHAO Guo-li, LV Xiao-feng, CHENG Qian-peng. The Military General Hospital of Beijing PLA, Beijing 100700, China

Corresponding author: LV Xiao-feng, E-mail: neifenmike@126.com

　　【Abstract】Objective To explore the relationship between oxidative stress and T2DM for observing the influential factors of insulin resistance and islet β cells. Methods Sixty newly diagnosed T2DM patients, FPG ≥ 10mmo l/L, without using oral hypoglycemic agents and/or insulin, were attributed to the experimental group, and 60 healthy people examined in the outpatient service were assigned to the control group. The laboratory tests with fasting blood for measuring FPG, 2hPG, serum glycated albumin (GA), triglyceride (TG), low density lipoprotein cholesterol (LDL), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), and malonaldehyde (MDA) to compute HOMA- IR and HOMA – β were performed in all subjects for study. Results (1) The levels of FPG, 2hPG, GA, TG, LDL, and HOMA- IR were significantly increased in the T2DM patients than in the healthy control group, and the difference was statistically significant (P<0.01). (2) Antioxidative enzyme such as SOD and GSH-Px and HOMA – β in the T2DM patients were lower than in the healthy control group, while the oxidative stress index MDA and HOMA- IR were higher than in the healthy people, and the differences were all statistically significant (P<0.01). (3) Pearson correlation analysis showed that the FPG was positively associated with the level of MDA (r= 0.944, P<0.01), the GA was positively associated with the level of MDA (r=0.392, P<0.05), the log-IR was positively associated with the level of FPG, GA, and MDA (P<0.01), and log-β was negatively associated with the level of FPG, 2hPG, and MDA (P<0.01), and the differences were all statistically significant. (4) The logistic regression analysis indicated that the SOD and MDA were the influencing factors of T2DM, and the differences were all statistically significant (P<0.05). Conclusion The T2DM patients have obvious glycolipid metabolism disorders and oxidative stress. The later takes a significant effect on secretion of islet β cells and insulin resistance.

　　【Keywords】Diabetes mellitus, type 2; Blood glucose; Oxidative stress; HOMA-β; HOMA-IR