2型糖尿病患者血糖控制水平对外周血白细胞端粒长度的影响  

The effect of glycemic control to the leukocyte telomere length in patients with Type 2 diabetes

作　　者：刘喆隆[1] 杨雁[1] 胡鹏[1] 严江涛[1] 余学锋[1] 张木勋[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院内分泌科,武汉430030

出　　处：《临床内科杂志》2012年第4期237-239,共3页Journal of Clinical Internal Medicine

基　　金：教育部博士点新教师基金资助项目（200804871047）;湖北省科技厅一般项目（2011CDB207）

摘　　要：目的通过检测2型糖尿病患者外周血白细胞端粒长度，探讨2型糖尿病患者血糖控制对端粒长度的影响。方法以47例健康者为对照组，选取43例病程在5年以上的2型糖尿病患者，其中糖化血红蛋白（HbAlc）≤7％且每月监测血糖次数〉t4次者纳入血糖控制良好组（22例）；而HbAlc〉9％且每月监测血糖次数〈4次者则纳入血糖控制不佳组（21例）。提取外周血白细胞DNA，定量聚合酶链反应（PCR）检测端粒长度比值来评估端粒长度。并检测空腹静脉血糖（FPG）、空腹静脉胰岛素水平（FIN）、高敏c反应蛋白（hs—CRP）及HbAlc，根据FPG及FIN评估胰岛素抵抗程度（HOMA—IR）。结果3组受试者年龄比较无显著差异。2型糖尿病患者中，血糖控制良好组和血糖控制不佳组的端粒长度均较对照组明显缩短，但血糖控制良好组的端粒显著长于血糖控制不佳组（P〈0．05）。血糖控制良好组的hs．CRP水平显著低于血糖控制不佳组。多元线性回归分析显示，hs—CRP及HbAlc与端粒长度呈显著负相关。结论2型糖尿病患者外周血白细胞端粒长度较正常对照者明显减短，有效的血糖控制能延缓端粒缩短的进程。Objective To detect the length of ihe leukocyte telomere in patients with type 2 diabetes （T2D）, and analyze the possible relative factor such as the degree of glycemic control, then to verify the possibility that telomere shortening might be affected by glycemic control in T2D. Methods Fortythree patients of T2D exceeded 5 years were divided into two groups, glycemic well controlled（WC） group （ n = 22）, defined as HbA1 c ≤ 7 % and the frequency of self-monitoring of blood glucose （SMBG） is over 4 times per month, glycemic poor controlled （PC） group （n = 21 ） as HbAlc 〉 9% and the frequency of SMBG less than 4, and age- and sex- matched non-diabetic normal control （NC） subjects （n =47 ） were selected from the outpatient department of Tongji Hospital. Using quantified PCR method we determined leukocyte telomere length ratio（T/S ratio）. The level of HbA1 c, hs-CRP, fasting plasma glucose and fast- ing plasma insulin were measured. Peripheral insulin resistance （homeostasis model assessment）, WHR and BMI were c.alculated. Results The three groups were age-matched. Mean（ ＋ SE） TRF lengths of the type 2 diabetic patients in both glycemic WC group and PC group were significantly shorter than those of control subjects,while those of WC group were longer than PC group. The level of hs-CRP of WC group was lower than that of PC group. Among the biochemical parameters, the levels of hs-CRP and HbA1 c were inverse correlated with shorten telomeres in all subjects. Conclusion Leukocyte telomere shortening occurs in T2D in Han Chinese population,which can be partly prevented by well glycemic control.

关 键 词：端粒 2型糖尿病 血糖控制 炎症 

分 类 号：R587.1[医药卫生—内分泌]