| Objective:Based on the analysis of different expression of heme oxygenase-1 (HO-1) in the mononuclear cells of peripheral blood and concentration of bilirubin and carboxyhemoglobin in patients of type 2 diabetes and arterial sclerosis,we further explore the glucose, insulin,urine protein, arterial elasticity affect expression of HO-1 and the role of HO-1.Method:We collected 85 cases of hospitalized patients admitted in our hospital from January to July in 2009, including 26 patients with hypertension;28 people with type 2 diabetes;31 patients with type 2 diabetes and hypertension,And 25 normal controls.the patients fulfilled the clinical diagnosis of hypertension in 2003 World Health Organization (WHO) criteria and diabetes in 1999 WHO criteria. We exclude patients with serious coronary heart disease events recently,severe liver disease,anemia,recent infection,history of exposure to heavy metals,acute glomerulonephritis,diabetic nephropathy,family history of kidney disease,hyperthyroidism,valvular heart disease.In order to analyze different factors on the impact of HO-1,we will grouped patients according to different factors which may influence HO-1.The first comparison group is blood glucose on the impact of HO-1; the second comparison group is 24-hour urine protein on the impact of HO-1,ruled out the history of acute glomerulonephritis,diabetic nephropathy, family history of kidney disease;the third comparison group is the application of insulin on the impact of HO-1;the fourth comparison group is that impact of arterial elasticity in HO-1.We collected blood samples of patients and extracted mononuclear cells for immunohistochemical.By results,we evaluated expression of HO-1 in the monocyte.And also we collected liver function tests,renal function,blood glucose,blood routine,blood gas in patients.Through the four comparison groups, we analyzed that glucose, insulin,urine protein,arterial elasticity affected expression of HO-1 in vivo in patients.Result:1.The first comparison group:the mean expression of HO-1 was 1.05±1.45 in the mononuclear cells of peripheral blood in 51 cases of normal blood glucose group. the mean expression of HO-1 was 3.07±1.98 in peripheral mononuclear cells in 59 cases of high blood glucose group. the mean expression of HO-1 in peripheral mononuclear cells in the high blood glucose group were significantly higher than the normal blood glucose group (P<0.01).We compared the carbon monoxide concentration (carboxyhemoglobin was formed by the carbon monoxide and hemoglobin in the body,so by comparing the concentration of carboxyhemoglobin in the two groups we can obtained comparison of the concentration of carbon monoxide in two groups),bilirubin concentration in two groups,They were the product after HO-1 catalyse heme. we saw the mean concentration of carboxyhemoglobin was 1.29±0.28 g/l,the mean total bilirubin concentration was 15.34±3.65μmol/l in the results of 26 cases of patients with normal blood glucose group;and the mean concentration of carboxyhemoglobin was 1.31±0.36g/l,the mean total bilirubin concentration was 14.74±4.83μmol/l in the results of 59 cases of patients with high blood glucose group.Through statistics analysised, two groups showed no significant difference in concentration of carboxyhemoglobin and total bilirubin (P>0.05).2.The second comparison group:the mean expression of HO-1 in the mononuclear cells of peripheral blood was 3.16±1.46 in the high proteinuria groups which was formed by 12 patients;the low proteinuria groups which was formed by 12 patients was 2.89±1.24. Two groups showed no significant difference (P>0.05)3.The third comparison group:the mean expression of HO-1 was 2.38±0.65 in insulin-treated group which was formed by 13 patients;Non-insulin-treated group which was formed by 18 patients was 3.44±1.50.Two groups showed significant difference (P<0.05).the mean expression of HO-1 of non-insulin-treated group was stronger than insulin treatment group in the mononuclear cells of peripheral blood. Morethan the two groups were compared with the mean concentration of total bilirubin and the mean concentration of carboxyhemoglobin in peripheral blood of patients.The result is that the mean concentration of total bilirubin was 15.40±3.51μmol/ l,the mean concentration of carboxyhemoglobin was1.43±0.42 g/l in the insulin-treated group;themean concentration of total bilirubin is 14.55±3.48μmol/l,the mean concentration of carboxyhemoglobin was 1.29±0.43 g/1 in the non-insulin-treated group.Two groups showed no significant difference (P>0.05)4.The fourth comparison group:the mean expression of HO-1 in mononuclear cells was 1.64±0.63 in peripheral blood of patients with high pulse pressure group which was formed by 14 patients; the low pulse pressure group which was formed by 12 patients was 1.66±0.65. Two groups showed no significant difference (P>0.05)Conclusion:High blood glucose level leads to increased expression of HO-1,But it has not benefited from the increased expression of HO-1.The possible reason is that elevated blood glucose decreases the body's sensitivity to endogenous carbon monoxide and HO was glycosylated.Expression of heme oxygenase-1 of the early type 2 diabetes and type 2 diabetes in late shows no difference.Insulin can not stimulate the expression of HO-1,the possible reason is the application of insulin controls blood glucose level effectively,while it could reduce the expression of HO-1,thus reducing the expression of HO-1 may indirectly reflect the effects of insulin treatment of type 2 diabetes.And the study find that the difference arterial elasticity does not change the expression of HO-1.
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