老年人群的2型糖尿病人常有环氧酶-介导的炎症和氧化应激
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2型糖尿病，是否涉及环氧酶（COX）-介导的炎症？未经研究过；细胞因子-介导的炎症与糖尿病的关联亦未完全明了。
方法及结果：人群中765名77岁男子样本中，其中112名患糖尿病，测15-keto-dihydro-前列腺素F2α（是前列腺素F2α的一种代谢物，同时又是一个COX-介导炎症的指标）。HsCRP、血浆淀粉样蛋白 A (SAA)、8-iso-FGF2α（一种花生四稀酸的非酶、自由基产物和氧化应激的一种指标）、生育酚。结果：糖尿病人的炎症指标升高（尿15-keto-dihydro-PGFα，P<0.001，CRP和SAA，P<0.05）。但标化BMI、腰围或空腹胰岛素后，CRP或SAA与糖尿病或SAA之间未见关联。糖尿病人尿中氧化应激指标8-iso-PGF2α增加（P<0.01）。新诊断的糖尿病人（诊断为糖尿病< 7年）尿中15-keto-dihydro-PGF2α增加，α-生育酚减少，8-iso-PGF2α无改变。
结论：本研究首次表明：老年男子的2型糖尿病与COX-介导的炎症有关，反映于前列腺素形成增加。糖尿病男子见到的细胞因子-介导的急性期蛋白的水平高，可能与肥胖及空腹胰岛素增高有关。结果进一步提示，糖尿病发病的早期出现慢性炎症，氧化损伤可能属较迟过程，可能与炎症有关。
Association of Type 2 Diabetes With Cyclooxygenase-Mediated Inflammation and Oxidative Stress in an Elderly Population
Background— Involvement of cyclooxygenase (COX)-mediated inflammation in type 2 diabetes has not been studied, and the association between cytokine-mediated inflammation and diabetes is not fully clarified.
Methods and Results— 15-Keto-dihydro-prostaglandin F2 (a metabolite of prostaglandin F2 and an indicator of COX-mediated inflammation), high-sensitivity C-reactive protein (CRP), serum amyloid protein A (SAA), 8-iso-PGF2 (a nonenzymatic, free radical product of arachidonic acid and an indicator of oxidative stress), and -tocopherol were measured in a population-based sample of 77-year-old men (n=765), in which 112 men had type 2 diabetes. The inflammatory indicators were increased in men with diabetes (urinary 15-keto-dihydro-PGF2, P<0.001, CRP and SAA, P<0.05). However, when adjusted for body mass index, waist circumference, or fasting insulin, no association was found between diabetes and CRP or SAA. The oxidative stress indicator 8-iso-PGF2 in urine was increased (P<0.01) in men with diabetes. Patients who were newly diagnosed with diabetes (<7 years since diagnosis) had increased urinary 15-keto-dihydro-PGF2 and decreased -tocopherol, but 8-iso-PGF2 was unaltered.
Conclusions— This is the first study to show that type 2 diabetes in elderly men is related to COX-mediated inflammation, reflected by enhanced prostaglandin formation. The high levels of cytokine-mediated acute-phase proteins observed in men with diabetes appear to be related to obesity and increased fasting insulin. The results further suggest that the appearance of chronic inflammation is an early process in the pathogenesis of diabetes, whereas oxidative injury may be a later process, possibly related to inflammation.
Circulation. 2004;109:1729-1734
方法及结果：人群中765名77岁男子样本中，其中112名患糖尿病，测15-keto-dihydro-前列腺素F2α（是前列腺素F2α的一种代谢物，同时又是一个COX-介导炎症的指标）。HsCRP、血浆淀粉样蛋白 A (SAA)、8-iso-FGF2α（一种花生四稀酸的非酶、自由基产物和氧化应激的一种指标）、生育酚。结果：糖尿病人的炎症指标升高（尿15-keto-dihydro-PGFα，P<0.001，CRP和SAA，P<0.05）。但标化BMI、腰围或空腹胰岛素后，CRP或SAA与糖尿病或SAA之间未见关联。糖尿病人尿中氧化应激指标8-iso-PGF2α增加（P<0.01）。新诊断的糖尿病人（诊断为糖尿病< 7年）尿中15-keto-dihydro-PGF2α增加，α-生育酚减少，8-iso-PGF2α无改变。
结论：本研究首次表明：老年男子的2型糖尿病与COX-介导的炎症有关，反映于前列腺素形成增加。糖尿病男子见到的细胞因子-介导的急性期蛋白的水平高，可能与肥胖及空腹胰岛素增高有关。结果进一步提示，糖尿病发病的早期出现慢性炎症，氧化损伤可能属较迟过程，可能与炎症有关。
Association of Type 2 Diabetes With Cyclooxygenase-Mediated Inflammation and Oxidative Stress in an Elderly Population
Background— Involvement of cyclooxygenase (COX)-mediated inflammation in type 2 diabetes has not been studied, and the association between cytokine-mediated inflammation and diabetes is not fully clarified.
Methods and Results— 15-Keto-dihydro-prostaglandin F2 (a metabolite of prostaglandin F2 and an indicator of COX-mediated inflammation), high-sensitivity C-reactive protein (CRP), serum amyloid protein A (SAA), 8-iso-PGF2 (a nonenzymatic, free radical product of arachidonic acid and an indicator of oxidative stress), and -tocopherol were measured in a population-based sample of 77-year-old men (n=765), in which 112 men had type 2 diabetes. The inflammatory indicators were increased in men with diabetes (urinary 15-keto-dihydro-PGF2, P<0.001, CRP and SAA, P<0.05). However, when adjusted for body mass index, waist circumference, or fasting insulin, no association was found between diabetes and CRP or SAA. The oxidative stress indicator 8-iso-PGF2 in urine was increased (P<0.01) in men with diabetes. Patients who were newly diagnosed with diabetes (<7 years since diagnosis) had increased urinary 15-keto-dihydro-PGF2 and decreased -tocopherol, but 8-iso-PGF2 was unaltered.
Conclusions— This is the first study to show that type 2 diabetes in elderly men is related to COX-mediated inflammation, reflected by enhanced prostaglandin formation. The high levels of cytokine-mediated acute-phase proteins observed in men with diabetes appear to be related to obesity and increased fasting insulin. The results further suggest that the appearance of chronic inflammation is an early process in the pathogenesis of diabetes, whereas oxidative injury may be a later process, possibly related to inflammation.
Circulation. 2004;109:1729-1734
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