Please use this identifier to cite or link to this item: http://hdl.handle.net/11455/51683
標題: Plasma Homocysteine、Folate and Oxygen-radical are related to Glycosylated hemoglobin in patients with Type 2 Diabetes Mellitus
第二型糖尿病病人糖化血色素濃度與血漿中同半胱胺酸、葉酸及氧化狀態之相關
作者: 陳玉楚
chen, yu chu
關鍵字: 反應蛋白C;糖化血色素;丙二醛;總抗氧化力;總同半胱胺酸;自由態同半胱胺酸;CRP;C-reactive protein;HbA1c;Glycosylated hemoglobin;MDA (malondialdehyde);ORAC;Oxygen radical absorbance capacity;tHcy:total Homocysteine;fHcy:free homocysteine 自由態同半胱胺酸
出版社: 食品科學系
摘要: 
Objectives: Diabetes, which has become an epidemic in the 21st century, is known to have high mortality rate and can lead to various chronic diseases. In addition to elevated oxidative stress, diabetics may also have higher plasma homomcysteine (Hcy) levels, but the evidence is inconsistent. Because both oxidative stress and Hcy are possible risk factors of atherosclerotic vascular diseases, we determined the relationships of oxidative stress and Hcy with glycated hemoglobin (HbA1c) in the diabetics. In addition, we determined plasma total Hcy (tHcy) and free Hcy (fHcy) because fHcy has been shown to be a more sensitive marker for ischemic stroke and cardiovascular disease.
Methods and design: We conducted a cross-sectional observation study by measuring plasma levels of HbA1c, Hcy, malodiadehyde (MDA, a marker of lipid peroxidation) and C-reactive protein (CRP, a marker of inflammation) in 136 Type2 diabetics (mean age 63.8) recruited from Taichung area in comparison with 110 healthy controls (mean age 60.1) from the same area. In addition, we measured plasma total antioxidant activity (oxygen-radical absorbance capacity, ORAC), which has not been studied in diabetes.
Results: The diabetics had significantly higher plasma levels of fHcy (P<0.050) and MDA (P<0.001) but had significantly lower values of ORAC (P<0.0001) than the healthy controls. However, the tHcy level was not significantly different. When all subjects were combined (136 diabetics plus 110 controls), we observed significantly positive correlations for HbA1c vs. fHcy (r=0.20;P<0.05) and HbA1c vs. CRP (r=0.23;P<0.001) but a negative correlation for HbA1c vs. ORAC (r=-0.48;P<0.0001). Logistic regression analysis showed that age, diabetes and HbA1C affected ORAC concentration. As the age increased by 1 year, the odds ratio of ORAC greater than 1.5 units was 0.94 times that of ORAC smaller than 1.5 units.(P=0.012).In addition , As the HbA1C increased,by 1﹪the odds ratio of ORAC greater than 1.5 units was 0.61 times that of ORAC smaller than 1.5 units.(P=0.0003).It means the higher the age and HbA1c, the lower ORAC.
Conclusions: The present study demonstrates that fHcy is a more sensitive marker than tHcy for diabetes. The diabetics have increased oxidative stress, as indicated by elevated HbA1c levels and lowered ORAC value in the plasma. The combination of elevated fHcy and oxidative stress in the diabetics may predispose the patients to various vascular diseases.The results suggest that the diabetics' patients should consume more antioxidate food to elevate plasma ORAC.

背景資料:糖尿病是21世紀主要的慢性病,死亡率高,而且會引發多種併發症,包括大小血管病變。糖尿病人除了有較高的氧化壓力之外,其血漿中的同半胱胺酸含量也可能高於正常人,但文獻報導並不一致。由於血糖控制不好和氧化壓力都是造成血管硬化的危險因子,因此本研究目的是比較第二型糖尿病患與非糖尿病患血漿中同半胱胺酸的含量與糖化血色素以及氧化壓力的差異以及其間的相關性。
受試者及試驗設計:受試者為台中縣社區衛生所管理的第二型糖尿病患者136人(平均年齡63.8歲),並以相同社區年齡接近的居民為對照組,共110人(平均60.1歲),採用橫斷式研究設計,檢測糖化血色素、總同半胱胺酸、自由態同半胱胺酸、丙二醛(脂質過氧化的指標)、葉酸、反應蛋白C、總抗氧化力等。
結果:糖尿病患者血漿中的自由態同半胱胺酸、丙二醛、反應蛋白C含量顯著高於對照組(P<0.05;p<0.001;p<0.001);總抗氧化能力則顯著低於對照組(P<0.0001)。總同半胱胺酸、葉酸在兩組間無顯著差異。在各生化值相關方面:糖化血色素與自由態同半胱胺酸呈正相關(r=0.20;P<0.05);糖化血色素與反應蛋白C呈正相關(r=0.23;P<0.001);糖化血色素與總抗氧化力呈負相關(r=-0.48;P<0.0001);反應蛋C與總抗氧化力呈負相關(r=-0.16;P<0.05)。經由邏吉斯迴歸分析,結果顯示:糖尿病本身、糖化血色素濃度增高、年齡增加等變項皆與血漿中總抗氧化力的降低有相關性。經羅吉斯迴歸分析影響總抗氧化力之因素。結果顯示,隨著年齡的增加,總抗氧化力大於1.5單位勝算是總抗氧化力小於1.5單位勝算的0.94倍;隨著HbA1c的增加,總抗氧化力大於1.5單位勝算是總抗氧化力小於1.5單位勝算的0.61倍。即年齡和HbA1c愈高,其總抗氧化力愈低。
結論: 本研究結果顯示, 對糖尿病人來說自由態同半胱胺酸較總同半胱胺酸具預警性的參考指標,而糖尿病患較非糖尿病者的總抗氧化力較低,且糖尿病患若血糖控制不好糖化血色素升高,會降低總抗氧化力,根據此一結果,糖尿病患宜多攝取抗氧化性食物以提升總抗氧化力。
URI: http://hdl.handle.net/11455/51683
Appears in Collections:食品暨應用生物科技學系

Show full item record
 

Google ScholarTM

Check


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.