Type 2 Diabetes Patients Serum Hydrogen Sulphide Levels Of Measurement And Correlation Studies

Objective:Hydrogen sulfide is endogenously produced in the mammalia- n vasculature from the amino acids cysteine and homocysteine by the pyridoxal-5,-phosphate-dependent enzyme cystathionine-γ-lyase(CSE). For a long time, Hydrogen sulfide has been thought as a kind of gas colorless, poisonous and smelling of rotten egg. It can cause the serious damage to many tissue and organs, even can cause death worst. But recent research shows that physiologic hydrogen sulfide levels inhibit oxidative stress, promotes stimulation of KATP channels, relaxation and vasodilation in vascular smooth muscle cell and decreases blood pressure. The physiologic hydrogen sulfide level has many physiological functions and regulates cardiovascular system in physiological pathology and closely associates with cardiovascular system disease. Animal experiments show that the H₂S levels are connected with endothelial function and insulin resistance. Diabetes is a kind of metabolic disease which is attributed to insulin secretion defects and (or) insulin action flaw and distinguished by high blood glucose. Currently there are various researches about H₂S and hypertension, hypoxic pulmonary hypertension and so on. Researches about H₂S and type 2 diabetes mostly came from animal experiments. Only little researches reported the relationship between plasma H₂S levels and type 2 diabetes patient abroad, and the domestic research has not been reported. The study first detected serum H₂S concentration changes from 99 cases of type 2 diabetes patients and 124 cases of non-diabetes people in Asian area to observe the relationship between H₂S and type 2 diabetes and its complications, hypertension and obesity.Methods:This population-based case-control study, randomly recruits 99 type 2 diabetics(74 male, 50 female)with mean age(50.19±14.19)years old in the First Hospital of Qin Huangdao from March,2010 to August, 2010. Meanwhile we randomly recruit 124 volunteers(74 male, 50 female)with mean age(50.39±15.39)years old. All patients'height, weight, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured, and their BMI were then calculated. Moreover, their serum H₂S level was measured with spectrophotometry and their TC, TG, LDL-C, HDL-C, FPG were measured with automatic biochemical analyzer. The research first studies serum H₂S concentration in type 2 diabetes in Asian area. Statistical analysis was performed using SPSS13.0 software package. P<0.05 was considered significant for all statistical analysis. The normal distribution data was described by Mean±SD, and t-test was employed to compare difference between T2DM group and control group. The normal distribution and homogeneity variance data employed completely random design analysis of variance, and q-test was employed to compare difference amongst several groups (studeni-Newlnan-Keuls). Dangerous factor analysis employed multiple linear regression analysis.Result:1 The comparison of clinical data between T2DM group and the control group1.1 In T2DM group, there are 62 male and 37 female, with average age 50.19±14.19, ranging from 15 to 83. In the control group, there are 74 male and 50 female, with average age 50.39±15.39, ranging from 23 to 88. There is not significant difference between the two groups in terms of sex and age(P>0.05).1.2 The levels of BMI, FPG, SBP, DBP, TG, TC and LDL-C in T2DM group were significantly higher than those in the control group (P<0.01) while the level of HDL-C was significantly lower than that in the control group (P<0.01).2.2 The level of H₂S in T2DM group was significantly lower than that in the control group (P<0.01).3 The comparison of H₂S concentration in different groups of BMI3.1 The level of H₂S in T2DM normal weight group was lower than that in the control normal weight group (P<0.05); The level of H₂S in T2DM overweight group was significantly lower than that in the control overweight group (P<0.01);The level of H₂S in T2DM obesity group was lower than that in the control obesity group (P<0.05).3.2 In T2DM group, the respective comparison of the levels of H₂S of normal weight group, overweight group, obesity group was not significantly different(p>0.05); In the control group, the respective comparison of the levels of H₂S of normal weight group, overweight group, obesity group was not significantly different(p>0.05).4 The comparison of each index between the non-hypertension group and the merging hypertension group in T2DM group In T2DM group, There were not significant difference between the non-hypertension group and the merging hypertension group two groups in terms of sex, age, H₂S, BMI, FPG, TG, TC, HDL-C and LDL-C(P>0.05).5 The comparison of each index of simple T2DM group, diabetic microangiopathy group, simple T2DM merging hypertension group and diabetic microangiopathy merging hypertension group in T2DM group.6 Multiple linear regression analysis Taking FPG as the dependent variable while taking sex, age, BMI, SBP, DBP, H₂S, TG, TC, HDL-C and LDL-C as independent variable, the multiple linear regression analysis shows that PFG was negatively correlated with H₂S(β=-0.047,P=0.009, 95%CI =-0.082 -0.012) and BMI (β=0.161,P=0.005,95%CI =0.048⁰.274) and positively correlated with HDL-C(β=-1.698,P=0.04,95%CI= -3.316 -0.08)。Conclusion:1 The level of serum H₂S of type 2 diabetes patient is significantly lower than that in the control group and negatively correlated with FPG. H₂S is the independent risk factor for FPG. Increasing the level of serum H₂S is likely beneficial to reducing the blood glucose.2 The level of serum H₂S is independent of BMI,SBP and DBP in type 2 diabetes patients. It explains that obesity and high blood pressure are not correlated with the level of H₂S in type 2 diabetes and the high blood glucose itself plays a conclusive part. Increasing serum H₂S level may prevent the occurrence of type 2 diabetes.