摘要
目的分析2型糖尿病患者糖、脂代谢与氧化应激和炎性反应等多个血清指标间的关系,探讨多因素间的联系。方法选择2型糖尿病患者95例,剔除有糖尿病酮症、高渗状态、心功能不全、肝炎(或转氨酶≥80U/L)、肾功能不全和有明确缺氧、严重应激状态(如心脑血管事件、严重感染、创伤、手术、消耗性疾病等)的糖尿病患者。检测患者的糖、脂代谢指标,包括空腹血糖(FPG)、餐后2h血糖(2hPG)、糖化白蛋白(GA)、糖化血红蛋白(HbA_(1c))、胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C);同时检测患者血氧化应激和炎性反应指标,包括8-羟基脱氧鸟苷(8-OHdG)、晚期蛋白氧化产物(AOPP)、丙二醛(MDA)、IL-6、胱抑素C(CysC)、可溶性细胞间黏附分子-1(sICAM-1)、同型半胱氨酸(Hcy)。采用典则相关分析法研究糖、脂代谢与氧化应激和炎性反应之间的联系。结果糖代谢的第1、第2对典则变量,脂代谢的第1对典则变量的相关系数均在0.662 2~0.980 1之间,提示糖、脂代谢与氧化应激和炎性反应之间存在中度以上的相关关系。由于各指标度量衡单位不同,为便于比较,对原始指标采用标准化变换后再计算其典则系数。在糖、脂代谢指标中,选择典则相关系数有统计学意义的1对或2对典则变量,将其对应的标准化典则系数线性组合分列如下。(1)血糖:V1=0.055 6(FPG)-0.231 2(2hPG)+0.165 2(GA)+1.153 8(HbA_(1c)),W1=0.175 2(8-OHdG)+0.742 2(IL-6)-0.082 4(CysC)-1.297 1(MDA)-0.118 5(sICAM-1)+1.409 6(Hcy)+0.019 3(AOPP);V2=-0.246 5(FPG)-0.168 9(2hPG)+1.093 8(GA)+0.228 0(HbA_(1c)),W2=0.908 9(8-OHdG)-0.173 8(IL-6)-0.122 5(CysC)+0.672 3(MDA)-0.119 7(sICAM-1)-0.648 6(Hcy)-0.161 1(AOPP)。(2)血脂:V1=-0.051 0(TC)-0.018 0(TG)+1.764 2(LDLC)-0.844 6(HDL-C),W1=0.954 6(8-OHdG)-0.009 9(IL-6)-0.008 6(CysC)+0.030 1(MDA)+0.006 6(sICAM-1)-0.004 1(Hcy)-0.139 3(AOPP)。其中V1和V2分别表示糖代谢或脂代
Objective To explore the correlations between the metabolism of glucose and lipid, oxidative stress and inflammation in patients with type 2 diabetes mellitus （T2DM）. Methods A total of 95 T2DM patients were recruited in this study. Exclusion criteria were as follows= diabetic ketosis, hyperosmotic state, cardiac insufficiency, hepatitis （or aminotransferase^80 U/L）, renal insufficiency, anoxia, severe stress state （such as cardiovascular and cerebrovascular events, serious infection, trauma, surgery, and chronic wasting diseases）. The parameters including fasting plasma glucose （FPG）, 2-hour postprandial plasma glucose （2hPG）, glycated albumin （GA）, glycosylated hemoglobin （HbAlc）, cholesterol （TC）, triacylglycerol （TG）, low density lipoprotein cholesterin （LDL-C） and high density lipoprotein cholesterin （HDL-C） were measured. Serum levels of 8-hydroxydeoxyguanosine （8-OHdG）, advanced oxidation protein products （AOPP）, malonaldehyde （ MDA）, interleukin-6 （IL-6）, cystatin C （CysC）, human soluble intercellular adhesion molecule-1 （slCAM-1） and homocysteine （Hcy） were also detected. Canonical correlation analysis was used to evaluate the relationships betweenthe metabolism of glucose and lipid, oxidative stress and inflammation. Results The correlation coefficients were 0. 662 2 - 0. 980 1 among the first pair and the second pair of canonical variables in the metabolism of glucose and the first pair of canonical variables in the metabolism of lipid. It indicated that there was above moderate correlation between the metabolism of glucose and lipid, oxidative stress and inflammation. In order to compare different variables, the standard transformation was applied and standardized canonical coefficients were counted. The linear combinations of the standardized canonical coefficients for those statistical significant canonical variables were expressed as below=① The metabolism of glucose= V1 = 0. 055 6 （FPG） - 0.231 2 （2hPG） ＋ 0. 165 2
出处
《上海医学》
北大核心
2017年第7期434-438,共5页
Shanghai Medical Journal
基金
上海市卫生和计划生育委员会课题资助项目(20134448)
关键词
糖
脂代谢
氧化应激
炎性反应
2型糖尿病
Glucose and lipid metabolism
Oxidative stress
Inflammation
Diabetes mellitus, type 2
