高血糖及血糖波动对白细胞磷酸戊糖途径及活性氧产量的影响  

Study on the effects of high glucose and glucose fluctuation on pentose phosphate pathway and reactive oxygen species production of whites blood cells

作　　者：桑丹 柳岚[1] 蒋凤秀[1] 陆泽元[1] 薛耀明[2] Sang Dan Liu Lan Jiang Fengxiu et al(Department of Endocrinology,the Fourth People＇ s Hospital of Shenzhen（ Futian Hospital） ,Shertzhen 518033, China)

机构地区：[1]深圳市第四人民医院(福田医院)内分泌科,518033 [2]南方医科大学南方医院内分泌科

出　　处：《临床内科杂志》2016年第12期820-822,共3页Journal of Clinical Internal Medicine

摘　　要：目的探讨高血糖及血糖波动对2型糖尿病（T2DM）患者外周血白细胞葡萄糖-6-磷酸脱氢酶（G6PD）活性、还原型烟酰胺腺嘌呤二核苷酸磷酸（NADPH）水平及活性氧（ROS）产量的影响，了解机体白细胞磷酸戊糖途径和ROS产量的变化。方法根据口眼葡萄糖耐量试验（OGTT）结果将试验对象分为正常糖耐量（NGT）组与T2DM组，选择OGTF120min作为观察点，用120min与0min血糖的差值表示血糖波动性，用细菌产物N-甲酰基-甲硫氨酰基-亮氨酰基苯丙氨酸（fMLP）激活白细胞，使之发挥杀伤功能，四氮唑蓝定量测定法检测G6PD活性；紫外分光光度计在340nm处检测细胞裂解上清液吸光值，计算白细胞内NADPH含量；流式细胞仪检测ROS水平。结果与NGT组相比，T2DM组0min与120min的G6PD活性、NADPH及ROS水平均明显降低（P〈0．05）；与0min相比，120min时T2DM组白细胞的G6PD活性、NADPH及ROS水平均明显降低（P〈0．05），NGT组差异无统计学意义（P〉0．05）；T2DM组血糖差值（△Glu）与△G6PD、△NADPH和△ROS呈明显相关性（P〈0．05）；NGT组△Glu与上述指标无明显相关性（P〉0．05）。结论血糖波动严重干扰T2DM患者白细胞的磷酸戊糖途径，使其ROS的产量显著下降，严重损害T2DM患者抗感染能力。Objective To investigate the effect of hyperglycemia and fluctuating hyperglycemia on glueose-6-phosphate dehydrogenase（G6PD） activity, reduced form of nicotinamide-adenine dinucleotide phosphate（NADPH） content and reactive oxygen species （ROS） quantity and evaluate the changes of pentose phosphate pathway（PPP） and ROS production of WBCs in patients with type 2 diabetes mellitus （T2DM）. Methods According to the results of OGTT, subjects were divided into normal glucose tolerance（NGT） group and T2DM group. Select OGTT 120min as an observation point and the glucose fluctuation was indicated by the difference of 0min and 120min glucose. Using bacteria product N-formylmethionyl-leucyl- phenylalanine （fMLP） to activate WBCs to play their killing function. Intracellular G6PD activity was measured by spectrophotometer and NADPH contents were assayed by measuring the absorbance of cell supernatant at 340 nm on spectrophotometer. Intraccllular ROS was evaluated by the staining fluorescent probe of 2＇ ,7＇-dichlorofluorescein diacetate and analyzed by flow cytometry. Results Compared with NGT group,G6PD activity,NADPH contents and ROS production of the T2DM group had significantly decreased at both 0 rain and 120 min（ P 〈 0.05 ） ; Compared to Omin, G6PD activity, NADPH contents and the production of ROS decreased even more strikingly in T2DM group at 120 min（P 〈0.05）, while there were no significant differences in NGT group（ P 〉 0.05 ）. AGlu had significant correlation with △G6PD, △NADPH and △ROS in T2DM group （P 〈 0. 05 ） , while AGlu had no significant correlatin with △G6PD, ANADPH and AROS in NGT group （P 〉 0.05 ）. Conclusion Blood glucose fluctuation severely interfere the PPP of WBCs, leading to the reduction of ROS production and serious impairments of anti-infection ability in T2DM patients.

关 键 词：2型糖尿病 血糖波动 磷酸戊糖途径 活性氧 

分 类 号：R541.4[医药卫生—心血管疾病]