糖尿病和糖尿病肾病对外周血单个核细胞能量代谢的影响  

Effect of diabetes and diabetic nephropathy on energy metabolism of peripheral blood mononuclear cells

作　　者：王玮[1] 谷伟军[1] 肖海英[1] 庞萍[1] 窦京涛[1] 张蝶 韩松梅[1] 雷永红[1] 梁允兴 Wang Wei;Gu Weijun;Xiao Haiying;Pang Ping;Dou Jingtao;Zhang Die;Han Songmei;Lei Yonghong;Liang Yunxing(Department of Endocrinology,Hainan Branch,General Hospital,CPLA,Sanya 572013,China)

机构地区：[1]解放军总医院海南分院内分泌科

出　　处：《海军医学杂志》2019年第6期537-540,601,共5页Journal of Navy Medicine

基　　金：2016年海南省重大科技计划项目(ZDKJ2016008)

摘　　要：目的检测并比较糖尿病患者和糖尿病肾病(diabetic nephropathy,DN)患者外周血单个核细胞能量代谢的差异,以期获得糖尿病肾病的早期诊断指标。方法随机选取健康志愿者和自2017年6月至2018年6月于解放军总医院海南分院内分泌科就诊的糖尿病患者、DN患者各50名,分别纳入健康组(HC组)、糖尿病组(DM组)、糖尿病肾病组(DN组)。采集所有受试者外周血,提取外周血单个核细胞(peripheral blood mononuclear cell,PBMC),利用Seahorse能量代谢分析仪检测PBMC在正常糖(5 mmol/L)负荷和高糖(20 mmol/L)负荷状态下的基础呼吸率、ATP相关呼吸率、糖酵解率、最大呼吸率及储备呼吸能力。结果 (1)DN组与DM组相比,患者年龄(62±13 vs. 48±18)、尿白蛋白/尿肌酐比值(ACR)、收缩压均显著升高(P<0.05);肾小球滤过率和胆固醇含量则显著降低(P<0.05)。DM组和DN组与HC组相比,体质量指数(BMI)(27±6 vs. 29±7 vs. 22±5)均显著增高(P<0.05)。(2)正常糖负荷下,DN组相较于DM组,基础呼吸率、ATP相关呼吸率以及糖酵解率差异均无统计学意义(P>0.05);但最大呼吸速率[(124.35±10.96) pmol/min vs.(151.84±20.81)pmol/min]和储备呼吸能力[(83.28±9.23)pmol/min vs.(114.48±24.01)pmol/min]却显著降低,差异有统计学意义(P<0.05)。(3)HC组和DM组在2种糖负荷条件下,各种能量代谢特征差异均无统计学意义(P>0.05);但DN组,高糖负荷相较于正常糖负荷,其最大呼吸率[(84.67±9.73)pmol/min vs.(124.35±10.96)pmol/min]和储备呼吸能力[(42.00±9.87)pmol/min vs.(83.28±9.23)pmol/min]均显著降低,差异有统计学意义(P<0.05)。结论 DN组相较于DM组,在正常糖负荷下,其PBMC潜在呼吸功能受损,同时对于高糖负荷应激的抵御能力明显较弱。Objective To detect and compare the differences in energy metabolism of peripheral blood mononuclear cells between the patients with diabetes mellitus(DM) and diabetic nephropathy(DN), so as to obtain early diagnostic indicators of diabetic nephropathy.Methods Healthy volunteers and 50 DM patients and DN patients admitted into the Department of Endocrinology, Hainan Branch, General Hospital, from June 2017 to June 2018, were enrolled for the study and were designated as the healthy control group(the HC group)(n=50), the diabetes mellitus group(the DM group)(n=50) and the diabetic nephropathy group(the DN group)(n=50). Peripheral blood samples of all the subjects were collected, and peripheral blood mononuclear cells(PBMC) were isolated. The loads of PBMC in normal sugar(5 mmol/L) and high sugar(20 mmol/L) levels were detected by Seahorse energy metabolism analyzer. Basal respiration rate, ATP-related respiration rate, glycolysis rate, maximum respiration rate, and reserve respiration capacity were obtained for the study.Results(1) The age of the the DM and DN groups was respectively and(48±18) years. As compared with those of the DM group, the albumin to creatinine ratio(ACR) and the systolic blood pressure all elevated significantly(P<0.05), while eGFR and cholesterol levels were significantly reduced(P<0.05). Compared with those of the HC group, the BMI levels(27±6 vs. 29±7 vs. 22±5) in the DM and DN groups all significantly elevated(P<0.05).(2) Under normal glucose load, there was no statistical significance in basal respiration rate, ATP-related respiration rate and glycolysis rate between the DN group and the DM group(P<0.05). However, the maximum respiration rate [(124.35±10.96)pmol/min vs.(151.84±20.81)pmol/min] and reserve respiratory capacity [(83.28±9.23)pmol/min vs.(114.48±24.01)pmol/min] all significantly lowered, with statistical significance(P<0.05).(3) There was no statistical significance in energy metabolism between the HC and DM groups under the 2 sugar loading conditions(P<0.05). Howeve

关 键 词：糖尿病 糖尿病肾病 外周血单个核细胞 线粒体 氧化呼吸功能 

分 类 号：R587.1[医药卫生—内分泌]