血糖波动对糖尿病大鼠肾脏病变及氧化应激的影响  

Effects of blood glucose fluctuation on kidney disease and oxidative stress in diabetic rats

作　　者：康省 苏珂[1] 龙艳[1] 王亚娇[1] 于健[1] 彭鹰[1] 胡璟[1] 黄漓莉[1] 江仁美[1] 

机构地区：[1]桂林医学院附属医院内分泌科,广西桂林541004

出　　处：《现代预防医学》2014年第8期1464-1467,1471,共5页Modern Preventive Medicine

基　　金：广西自然科学基金项目(2012GXNSFAA053085);广西教育厅科研课题(201204LX245)

摘　　要：目的观察血糖波动对糖尿病大鼠肾脏病变及氧化应激的影响。方法 SD大鼠40只,随机分为4组:正常对照组(A组)、正常血糖波动组(B组)、糖尿病稳定性高血糖组(C组)和糖尿病血糖波动组(D组)。采用链脲佐菌素(STZ)60 mg/kg腹腔注射诱发糖尿病。血糖波动组每天错时腹部皮下注射胰岛素及灌葡萄糖造成血糖波动模型。实验9周后采血,检测空腹血糖(FBG)、肌酐(Cr)、尿素氮(SUN)、糖化血红蛋白(HbA1c)、24 h尿微量白蛋白含量,计算血糖水平标准差(SDBG)、最大血糖波动幅度(LAGE)、平均血糖水平(MBG),运用比色法检测血清中抗氧化酶的活性,包括总超氧化物歧化酶(TSOD)、谷胱甘肽过氧化物酶(GSH-Px)、过氧化氢酶(CAT)、丙二醛(MDA)的含量,通过光镜观察肾脏显微结构改变。结果 A组与B组间各指标无显著差异,C、D组与A、B组比:体重明显减轻;空腹血糖、血糖水平标准差、最大血糖波动幅度、平均血糖水平、肌酐、尿素氮、糖化血红蛋白、24h尿微量白蛋白明显升高;抗氧化物酶TSOD、GSH-Px、CAT活性明显下降,而MDA明显升高;组织形态学观察表明:肾小球体积增大、囊腔扩张破裂,肾小球细胞减少,炎细胞浸润,肾小管结构紊乱,D组比C组以上指标的变化更加明显。结论血糖波动能加重糖尿病大鼠肾脏病变及氧化应激反应,在糖尿病肾病发病机制中起到重要作用。Objective This study was conducted to explore the effects of blood glucose fluctuation on kidney disease and oxidative stress in diabetic rats. Methods SD rats were divided into four groups： control group （group A）, blood glucose fluctuation normal group （group B）, stable high blood glucose diabetic group （group C） and blood glucose fluctuation diabetic group （group D）. Diabetes in rats were induced by intraperitoneal injection of STZ, high blood glucose fluctuation animal model was induced by subcutaneous injection of insulin and intragastric administration of glucose at different time points every day. Nine weeks after the initiation of the experiments, the level of blood glucose, creatinine, urea nitrogen, and glycosylated hemoglobin in blood sample were measured. The SDBG, LAGE, and MBG were calculated in order to identify microalbuminuria. The activities of serum antioxidant enzymes, includ- ing the total superoxide dismutase （TSOD）, glutathione peroxidase （GSH-Px）, catalase （CAT）, and malondialdehyde （MDA）, were measured by chromatometry. And the change of kidney microstructure was observed by optical microscope. Results There were no significant differences between group A and B. When group C and D were compared with group A and B, significant changes were observed, including reduction in weight, increase in fasting blood-glucose （FBG）, SDBG, LAGE, MBG, Cr, SUN, HbAlc and MAG, decrease in the activity of TSOD, GSH-Px, CAT, and increase in MDA activity. Inspection of the renal tissue by optical microscope demonstrated that there were volume increase, expansion/rupture of the glomerulus, reduction in the number of glomerulus cells, in- filtration of inflammatory cells, and renal tubular structure disorder. The changes were more significant in group D than group C. Conclusion Blood glucose fluctuation can aggravate kidney disease and oxidative stress in diabetic rats, and play an important role in the pathogenesis of diabetic nephrupathy.

关 键 词：血糖波动 氧化应激 糖尿病大鼠 糖尿病肾病 

分 类 号：R-332[医药卫生]