Accumulation of phosphatydilcholine-hydroperoxide in dialysis patients with diabetic nephropathy.
Accumulation of phosphatydilcholine-hydroperoxide in dialysis patients with diabetic nephropathy.
复制标题
糖尿病肾病透析患者体内磷脂酰胆碱过氧化氢的积累。
作者：
T. Sanaka;C. Takahashi;M. Sanaka;C. Higuchi;M. Shinobe;Y. Hayasaka;T. Miyazawa;S. Ishikawa;H. Nihei;Y. Omori
本文应用荧光-高效液相色谱法测定非胰岛素依赖型糖尿病（DM）血液透析（HD）患者血浆中磷脂酰胆碱氢过氧化物（PCOH）的含量，评价DM患者血浆脂质过氧化反应。33例糖尿病肾病尿毒症患者，每周使用聚甲基丙烯酸甲酯膜进行12小时HD。将22例糖尿病患者分为年龄、性别相匹配的两组，分别给予α-生育酚500 mg/d和普罗布考600 mg/d治疗。选择50例年龄、病程、性别匹配的无终末期肾病（ESRD）的DM患者作为阳性对照。两个DM患者的血浆PCOOH水平显著升高，而正常对照组的血浆PCOOH为227.0 +/- 68.7 pmol/ml。接受HD的DM患者的血浆PCOOH水平显著高于非ESRD患者（1，330.8 +/- 642.7 pmol/ml vs. 756.6 +/- 431.9 pmol/ml，p < 0.025）。偏相关系数分析表明，糖尿病患者血浆PCOH水平与HD时间呈极显著正相关（p < 0.01），但单次HD并未引起脂质过氧化反应的显著增加。与常规组相比，抗氧化剂组的血浆PCOH大致保持在与基线相似的水平。从这些结果中，我们得出结论，HD会加剧脂质过氧化反应，这种氢过氧化物的积累可能是导致肾功能不全的糖尿病患者动脉粥样硬化加速进展的原因。为了减少PCOOH和减缓动脉粥样硬化性血管疾病的进展，值得尝试给予自由基清除剂。
Plasma lipid peroxidation in noninsulin dependent diabetes mellitus (DM) patients were evaluated in DM patients undergoing hemodialysis (HD) by means of a chemiluminescence-HPLC for the specific determination of phosphatidylcholine hydroperoxide (PCOOH). Thirty-three uremic patients with DM nephropathy, undergoing 12 hours HD a week using polymethylmethacrylate membrane, were studied. Of them 22 DM patients on HD were divided into 2 age and sex matched groups treated and conventional group in order to clarify therapeutic effect of 500 mg alfa-tocopherol and 600 mg probucol daily. Fifty DM patients without end-stage renal disease (ESRD) who were age-, period of diabetes-, and sex-matched, were selected as positive control of the subjects. Plasma PCOOH levels were significantly elevated in both DM patients, while the plasma PCOOH in normal controls were 227.0 +/- 68.7 pmol/ml. Plasma PCOOH levels of DM patients undergoing HD were significantly higher than that of patients without ESRD (1,330.8 +/- 642.7 pmol/ml vs. 756.6 +/- 431.9 pmol/ml, p < 0.025). Partial correlation coefficient of plasma PCOOH level demonstrated PCOOH and period of HD in DM patients were highly significantly positively correlated (p < 0.01), although single session of HD was not found to produce significantly increased lipid-peroxidation. Plasma PCOOH roughly remained within similar levels as base lines by medication with anti-oxidant compared to that of conventional group. From these results we conclude that HD intensifies lipid peroxidation and such accumulation of hydroperoxide could account for accelerated progress of atherosclerosis in DM patients with renal insufficiency. It is worthwhile to try an administration of free radical scavenger in order to reduce PCOOH and slow down the progression of atherosclerotic vascular disease.