The Relationship Of Oxidative-antioxidative Balance Disturbance And Nephropathy In Diabetes Mellitus

The rate of disability and mortality in diabetes mellitus increase gradually, a major cause of this was diabetic nephropathy which occurrence was a complicated pathology process and the pathogenesy still to remain fully undistinct at present.Recent researches have shown that the cause of diabetic nephropathy was relevant to oxidative stress.The increase product of oxygen free radicals or decrease of antioxidant agent and antioxidase enzyme activity would cause imbalanced plasma oxidants and antioxidants in diabetes mellitus patients,generating oxidative stress in nephridial tissue.Increasing oxygen free radical can directly or indirectly priming diabetic nephropathy and promote its development through up-regulating the expression of many cytokine to do harm to renal cells.Since there had been imbalanced plasma oxidants and antioxidants in diabetes mellitus patients before vascular lesion appearing, associated with antioxidant to prevent the generation of peroxidate or interfere in its effect on the base of tradition therapy may be delay or prevent the development of diabetic nephropathy.This will be an important prospect to prevent and cure diabetic nephropathy.On the basis of WHO 1999,diabetic diagnostic criteria and typing standard,we selected 120 diabetics who came to the third medical college of JiLin University from fourth,2007 to January,2008.Four cases were of type 1 diabetes and one hundred and sixteen were type 2 diabetes.The microalbuminuria were examined in the 120 patients according to diabetic nephropathy diagnostic criteria to find out patients with diabetic nephropathy. They were excluded from cardiovascular disease,pulmonary disease,liver desease and nephrosis and cerebropathy,without tumor inflammation, autoallergic disease,hematonosis,radiation factors and besides primarily or else succeeding renal disease and urinary tract infection,blood pressure were under 140/90mmHg.normal renal function.1.The diabetes patients were divided into two groups on the basis of positive or negative of DEN:DNN group,there are 54 cases,including 28 males and 26 females,age from 25 to 67 years old(average 50.4±9.8).The course of diabetes mellitus was from 1 week to 16 years.microalbuminuria was under 30 mildigram per 24 hour.DEN group,there were 66 diabetes, consisting of 34 males and 22 females,age from 28 to 76 years old(average 53.5±9.9).The course of diabetes mellitus was from 4 months to 20 years. microalbuminuria was over 30 mildigram and under 300 mildigram per 24 hour.There is no significant difference between the two groups in sex,age and course of diabetes.2.The DEN group was divided into two groups according to the level of their fasting plasma glucose(fpg).Group DN1:fpg was from 3.9 millimol per liter to 14.0 millimol per liter,37 cases,including 20 males and 17 females,age from 28 to 76 years old(average 55.43±10.03).Group DN2:fpg was over 14 millimol per liter,without ketoacidosis.29 cases consisting of 15 males and 14 females,age from 29 to 71 years old(average 51.13±9.38).There is no significant difference between the two groups in sex,age,course of diabetes and microalbuminuria.3.As control group there were 25 healthy people who took a health check-up in the out-patient department of our hospital.It consisted of 13 males and 12 females,age from 29 to 70 years old(average 52.0±9.7).They were excluded from cardiovascular disease,Pulmonary disease,liver desease and nephrosis.They had no diabetes and hypertension.The level of ROS,MDA,GSH-PX,SOD,blood sugar,liver function and renal function were examined in all patients and all measurement data was delivered through means value standard errand((?)±s),We analyzed the average difference through F test,It has significant difference when p＜0.05.In this investigation:1.The serum ROS and MDA were increased distinctly in the DEN and DNN groups than in the control,while the serum GSH-Px and SOD decreased obviously in the two groups than in the control(P＜0.05),the difference has statistical significance,the serum ROS and MDA were increased distinctly in the DEN group than in the DNN group,while the serum GSH-Px and SOD decreased obviously in the DEN group than in DNN group(P＜0.05),the difference was significant.Oxygen free radical had important relation to diabetic nephropathy,participating the occurrence and development of diabetic nephropathy.2.The serum ROS and MDA were increased distinctly in DN1 and DN2 groups than in the control,while the serum GSH-Px and SOD in the two groups decreased obviously than in the control,the difference was significant (P＜0.05);The serum ROS and MDA were increased distinctly in DN2 group than in DN1 group,the serum GSH-Px and SOD in DN2 group decreased obviously than in DN1 group,the difference was significant(P＜0.05).There was imbalanced plasma oxidants and antioxidants in diabetic nephropathy patients,and the imbalance would be more distinct with the increase of blood sugar,the result suggested chronic hyperglycemia may cause large quantitative oxygen free radical,and simultaneously dissipate a great quantity antioxidants, accelerate the development of diabetes.In a word,there was imbalanced free radicals and antioxidant defense systems in diabetic and the disequilibrium in early period diabetic nephropathy patients would be more obvious than diabetic without nephropathy and the imbalance would be more distinct with the increase of blood sugar in early period diabetic nephropathy patients,thus to think oxygen free radical induced by hyperglycemia participates the emerging process and the development of diabeteic nephropathy as well as to have possible nosazontology significance. By the examination of lipid peroxidation and antioxidase systems we could discover diabetic nephropathy early and carry out effective,reasonable antioxidant pretreatment.