谷胱甘肽系统对2型糖尿病患者冠状动脉病变程度的影响

目的探讨谷胱甘肽系统对2型糖尿病(T2DM)患者冠状动脉病变程度的影响。方法选取行冠状动脉造影术的患者236例,分为正常糖耐量(NGT)组126例,T2DM组110例,检测患者的血液生化指标以及还原型谷胱甘肽(GSH)、GSH过氧化物酶(GSH-Px)和谷胱甘肽还原酶(GR)的活性。根据冠状动脉造影结果,采用Gensini评分系统对每支血管病变程度进行定量评分。结果 T2DM组血浆GSH[(3.87±1.55)μg/L vs(4.45±1.94)μg/L]、GSH-Px[(0.29±0.05)ng/L vs(0.35±0.08)ng/L]和GR[(0.19±0.07)ng/L vs(0.26±0.08)ng/L]活性明显低于NGT组,差异有统计学意义(P<0.05)。校正年龄、体重指数、血压、血脂、空腹血糖、空腹胰岛素、餐后2h血糖、餐后2h胰岛素、糖化血红蛋白因素后,T2DM组GSH、GSH-Px、GR活性与Gensini积分呈负相关(P<0.05,P<0.01)。T2DM组GSH、GSH-Px和GR活性对Gensini积分的影响作用最大。结论 T2DM患者血浆GSH、GR和GSH-Px活性的降低与冠状动脉病变程度具有一定的负相关性,且为该人群冠状动脉病变的独立影响因素。

Effect of glutathione system on coronary artery lesion in type 2diabetes mellitus patients

Objective To study the effect of glutathione(GSH)system on coronary artery lesion in type 2diabetes mellitus(T2DM)patients.Methods Two hundred and thirty-six patients who underwent coronary angiography were divided into normal glucose tolerance(NGT)group(n=126)and T2 DM group(n=110).Their biochemical indexes were assayed and serum levels of GSH,GSH-Px and GR were meausred.Their coronary artery lesion was scored according to the Gensini scoring system.Results The serum levels of GSH,GSH-Px and GR were significantly lower in T2 DM group than in NGT group(3.87±1.55μg/L vs 4.45±1.94μg/L,0.29±0.05ng/L vs0.35±0.08ng/L,0.19±0.07ng/L vs 0.26±0.08ng/L,P<0.05)and negatively related with the Gensini score after adjustment for age,BMI,blood pressure,blood lipids,fasting glucose and insulin,postprandial 2hglucose and insulin,HbA1c(P<0.05,P<0.01),indicating that the serum levels of GSH,GSH-Px and GR could significantly influence the Gensini scores in T2 DM patients.Conclusion Low serum levels of GSH,GSH-PX and GR are negatively related with coronary artery lesion and are the independent factors for coronary artery lesion in T2 DM patients.