The Relationship Between Serum3-deoxyglucosone And Disorder Of Glycometabolism In Elderly, As Well As The Syndrome Of TCM

Object: We detected the serum level of3-Deoxyglucosone (3-DG) of the elderly without diabetes, then investigated the relationship between3-DG and the disorder of glycometabolism, as well as the syndrome of TCM. Methods:We studied the retired people beyond the age of50years of women and55years of men, who visited the department of health of Chinese medicine hospital of Soochow. The subjects had a history of hyperglycosemia and nephritic which could affect the level of serum3-DG were excluded when assessing the level of plasma3-DG of non-diabetic. We assayed their serum levels of3-DG (initial inspection) and evaluated the ratio of high level among the elderly. On the other hand, we analyzed the possible factors for3-DG raise. Meanwhile, we investigated the effects diets conducted for3-DG raise by a questionnaire. Subjects who got high levels of3-DG were asked to remeasure serum3-DG after2years, and subjects had normal level of3-DG were random sampled as the control group. Every subject also took an oral glucose tolerance test-insulin radioimmunoassay (OGTT-IRI) after2years. Last, we differentiated the syndromes of the disorder of glycometabolism in primary state with TCM, as well as the syndromes of high level of3-DG, and investigated the relationship between them. Results:1) the results of initial inspection:49subjects (36.57%) of the134retired people had the level of serum3-DG>70ng/ml, while14subjects (10.45%)>300ng/ml; compared with50-59age group,60～69age group had a higher level of3-DG and much larger constituent ratio of people had3-DG>70ng/ml (both p<0.05), no difference was found in the constituent ratio of the3-DG>300ng/ml between the two groups (p>0.05); obesity group had a higher level of3-DG than overweight group, and overweight group had a higher level of3-DG than normal weight group, both p>0.05, and the subjects with BMI between≥26had the highest level of3-DG, compared with<24and24～26group, both p<0.05. The subjects with non-light diet had higher levels of serum3-DG than the light diet(p>0.05).2)2years later, the ratio of serum3-DG>70ng/ml in50～59and60～69age groups were64.29%and93.75%, respectively, approached significance (p=0.072); The people of continuing high level of3-DG in this two age group were7/14and9/16, with no difference (p=0.999),2/14in50～59group and6/16in60～69group that level of3-DG were fluctuating (p=0.226); the results suggested that age maybe one reason affected the level of serum3-DG. And it didn’t show any difference of fasting blood glucose, postprandial blood glucose with2hours after meal, fasting insulin, and insulin sensitivity indexes between the two age groups and BMI groups.3) It was about72.73%of the subjects had continuing high level. The continuing high group had the highest level of3-DG, compared with the normal and fluctuating group, the p were<0.01, and<0.05. The continuing high group had a higher level of fasting blood glucose, postprandial blood glucose (1hours and2hours after meals), HbAlc and fasting insulin, compared with the normal and fluctuating groups, but a lower insulin sensitivity index; the continuing high group had the highest incidence rate of disorder of glycometabolism, compared with the other two groups(but p>0.05). Statistically significant correlations between3-DG level and fasting blood glucose (r=0.401), fasting insulin (r=0.414), HOMA insulin resistance (r=0.492), as well as insulin sensitivity index (r=-0.492) were found. But the HOMA β cell index and△I60/△G60among the three groups were similar. But the△I60/△G60of the continual high group was significantly lower than the fluctuating group (p>0.05), and normal group (p<0.05) when given IR correction.4) Yin-deficiency and dampness-heat syndrome were the main syndromes of prediabetic state and new diabetics, as well as the of high level of3-DG. Conclusion:Age and obesity maybe the reasons for serum3-DG level elevated in elderly without diabetes, a continuing high level of3-DG could result in impaired glucose regulation (conclude impaired fasting glucose and impaired glucose regulation).3-DG maybe one of the risk factors for disorder of glycometabolism, and leading to the development of diabetes with the mechanism of influent the sensitivity of insulin, consequently lead to insulin resistance and insufficient insulin after meals in elderly. And a dmapness-heat damages Yin is the main pathogenesis of3-DG conducts on the development of diabetes.