1型糖尿病儿童氧化状态及其与血糖状态的关系

Nada El-Din Elshalkami, N. Salem, W. Elshabrawy, Samir Abou-Elhassan
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引用次数: 1

摘要

糖尿病是学龄儿童最常见的疾病之一。1型糖尿病(T1DM)血糖控制不良通常会导致更多的氧化应激,增加氧自由基的产生,以及更多的糖尿病并发症。氧化应激在糖尿病并发症的发展中起着关键作用,包括微血管和心血管。糖尿病的代谢异常导致大、小血管内皮细胞和心肌的线粒体超氧化物过量产生。目的本研究的目的是评估儿童T1DM的氧化状态及其与血糖状态的关系。患者与方法本研究为病例对照研究,共纳入50例儿童。第一组从2020年12月至2021年12月在曼苏拉大学儿童医院内分泌科门诊就诊的T1DM患者中选取30名2-12岁的男女儿童,并与20名年龄匹配和性别匹配的健康对照组儿童进行比较。结果与对照组相比,患者血清丙二醛(MDA)及MDA/总抗氧化能力比值显著升高。MDA和MDA/总抗氧化能力比值可作为区分病例和对照的可靠预测指标,具有较高的敏感性和特异性。然而,它们不能作为鉴别微量白蛋白尿病例与非微量白蛋白尿病例的可靠指标。氧化/抗氧化状态似乎在糖尿病控制不佳的病例中显著增加,其次是糖尿病控制组,最后是健康对照组。结论T1DM患者氧化应激水平明显升高,尤其是控制较差的T1DM患者。此外,氧化应激标志物可作为T1DM的有效标志物。
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Oxidative status and its relationship with glycemic state in children with type 1 diabetes mellitus
Background Diabetes represents one of the most common diseases in school-aged children. Poor glycemic control in type 1 diabetes mellitus (T1DM) usually leads to more oxidative stress, increased production of oxygen-free radicals, and more diabetic complications. Oxidative stress plays a pivotal role in the development of diabetes complications, both microvascular and cardiovascular. The metabolic abnormalities of diabetes cause mitochondrial superoxide overproduction in endothelial cells of both large and small vessels and also in the myocardium. Aim The aim of the current study was to assess the oxidative status and its relationship with glycemic state of T1DM in children. Patients and methods This was a case–control study conducted on 50 children. The first group enrolled 30 children aged 2–12 years of both sexes with T1DM selected from patients attending the outpatient clinic of endocrinology unit of Mansoura University Children’s Hospital in the period between December 2020 and December 2021 and were compared with 20 age-matched and sex-matched children who served as healthy controls. Results The malondialdehyde (MDA) and MDA/total antioxidant capacity ratio were significantly increased among cases compared with the control group. MDA and MDA/total antioxidant capacity ratio could be used as reliable predictors for differentiating between cases and controls with high sensitivity and specificity. However, they could not be used as a reliable indicator for differentiation between cases with microalbuminuria from case without. Oxidant/antioxidant status seemed to be significantly increased among cases with poor diabetic control followed by controlled diabetic group and lastly the healthy control group. Conclusion Cases with T1DM were associated with a significant increase in oxidative stress, especially in poor controlled ones. Additionally, oxidative stress markers could be used as valid markers for T1DM.
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