The Study Of Trace Elements In The Serum And Urine Of Diabetes And Chronic Complications

Diabetes mellitus（DM） is metabolic diseases characterized by chronicblood glucose level rising, caused by insulin secretion and (or) the defects ofinsulin. The disorder of glucose metabolism can cause dysfunction and failureof eye, kidney, heart, blood vessels and nervous system. A variety of enzymesand hormones involved in glucose metabolism, and trace elements is an integralpart of these enzymes and hormones, and play an important role in cellularmetabolic processes and energy sources metabolic processes. Trace elementshave closely relationship with the pathogenesis of diabetes, chroniccomplications, prevention and treatment of diabetes.Methods: From January2010to October2011, the First Hospital of JilinUniversity diagnosis the T1DM, T2DM, impaired fasting glucose, impairedglucose tolerance, type2diabetic nephropathy in type2diabetic retinopathy,type2diabetes peripheral neuropathy in patients with the condition of serumand urine glucose metabolism, lipid metabolism, CRP, trace elements and renalfunction.Results:1. IGT, IFG serum Cu higher than the control group, but no significantdifference with T2DM group. IFG group serum Mg is lower than the controlgroup, but no significant difference with T2DM group.2.T1DM serum Zn, Mg and Cr is lower than the control group, the urineZn, Mg and Cr compared with control, serum Cu is higher than the controlgroup, Zn/Cu ratio lower than the normal control group, and T2DM Therewere no significant differences in CRP were significantly higher than othergroups, with T1DM serum Fe is higher than the control group, and was positively correlated with HbA1c.3.T2DM serum Zn, Mg, Cr, Se is lower than the control group, the urineZn, Mg, Cr, Se is higher than the control group, serum Cu is higher than thecontrol group, Zn/Cu ratio is lower than the control group and no significantdifference with T1DM. According to four hours stages of insulin secretion,insulin secretion and the Cr content of the T2DM group was positivelycorrelated, especially in the0stage.4. The changes of trace elements in T2DM with microvascular disease4.1Diabetic nephropathy(DN) serum Zn, Fe, Mg and Zn/Cu is lowerthan the control group and T2DM group, urine Zn, Fe and Mg is higher thanthe control and T2DM group, serum Cu is higher than control group, but withT2DM group no significant changes.Serum Cr is lower than the control group,no significant changes with T2DM group. According to the endogenouscreatinine clearance rate, serum Zn, Cu, Cr, Fe and Se, show differentreduction，urine Zn，Cr，Fe，Se and Mg increased, serum Zn and urine albuminwere negatively related. Serum Cu is positively correlated with urine albumin.But in the urine, Fe has show a significant positive correlation with it.4.2Diabetic retinopathy(DR) serum Cu is higher than the control group,no significant difference with T2DM group, DR serum Se and Mg is lower thanthe control group, no significant difference with T2DM group, The CRP issignificantly higher than the control group and T2DM group in DR. The urineZn, Cu, Fe and Mg is higher than the control group, urine Cr is also higher thanthe control group, but no significant difference with T2DM group.According tothe clinical stages of DR, it divided into six stages, serum Cu and stages of DRhave positive correlation, but the serum Zn, Se, Fe and Mg with the severity ofdisease have different reduction of trace elements, although the trace elementsof urine do not have significant difference, except Zn in the stage Ⅵ.4.3Diabetic peripheral neuropathy(DPN) serum Cu is higher than the control group, but no significant difference with T2DM, serum Cr, Mg is lowerthan the control group, no significant difference with T2DM, but CRP is higherthan the control group. DPN urine Zn, Cr, Mg and Fe is higher than the control.5The trace elements of treatment in one month by simvastatin,fenofibrate, probucol in T2DM with obesityAfter one month treatment with simvastatin has significantly reduced TC,LDL, but the reduction of TG, Lp (α) and CRP is not significant, also can notsignificantly increased HDL. We also observed increase serum Zn，but othertrace elements had no significant difference. Urine Zn and Mg significantlydecreased, but Cu increased after simvastatin treatment.After one month treatment with fenofibrate can decease TC, TG, LDL andCRP, also can increase HDL, but the role of influence of Lp (α) after treatmentis not significant, in the experiment after treatment serum Zn, Cu and Feincreased and Mg decreased, urine Zn, Cu, Cr, Mg reduced and Fe increased.After one month treatment with Probucol can lower TC, LDL and havesignificant reduction of Lp (α) and CRP, but no significant difference with TGand HDL, and we can observe serum Zn, Cu, Fe, Cr reduce，Mg had increased，and urine Zn, Cu and Cr and Mg reduced.Conclusion:1. IGT and IFG have appear obvious disorder of trace elements, especiallyZn, Mg and Cu.2. T1DM Cr has involved in insulin action and insulin, C-peptide secretionthere is a certain relationship. T1DM insulin secretion absolute reduction in thelack of Zn, resulting in Cu Chu to stay in the body.3. T2DM levels of trace elements is obviously not in equilibrium. The lackof synthesis, and insulin secretion related Zn and Cu is relatively higher, withthe combination of insulin to its receptor and play the role of Cr deficiency, theoxidation reaction with the peroxide formation related to Se deficiency. 4. Trace elements in the process of diabetic nephropathy with the severityof the disease gradually reduce, and showing a correlation with urinary albumin.Levels of trace elements in diabetic retinopathy and retinal microvasculardisease severity. Simvastatin, fenofibrate, probucol three differentpharmacological effects of lipid-lowering drugs, different types ofhyperlipidemia in T2DM, while changing the body’s fat metabolism, it alsocaused changes in trace elements, collaborative treatment should be concernedabout the changes of trace elements.