| Objective:8-iso-prostaglandin F2α(8-isoPGF2a) is the end product of unsaturated fatty acids formed through free radical catalyzed reaction (non-enzymatic reaction). Arachidonic acid is catalyzed by oxygen free radical that formed peroxide intermediates, and finally generated Iso-PGF2α. Iso-PGF2oc is a group of isomers derivatives, the highest concentrations is8-isoPGF2α. Its synthesis and releasing are stable, the half life of the product is limited, and is not affected by dietary lipids and drugs. Therefore,8-isoPGF2α is considered the ideal biochemical indicator of antioxidant efficacy and the gold standard of oxidative stress. High sensitive C reactive protien(hs-CRP) is the same protein as C reactive protien(CRP), named only because the method of determination is more sensitive. CRP is an acute phase protien, it participant in a variety of pathophysiological process of the body, play an important dual role of anti-inflammatory and pro-inflammatory. CRP has a high application value in infectious diseases and connective tissue disease, while the hs-CRP has been pay more attention to cardio-vascular and cerebrovascular diseases and diabetes. In this study, combination treatment of insulin and metformin, metformin alone, diabetes untreated and nomal subjects are selected and divided into four groups, observed and analysed the8-iso-PGF2α and hs-CRP levels in blood to explore the effects of different treatment to8-iso-PGF2α and hs-CRP, and the clinical value for diabetes therapy and prevent the development of diabetic complication.Methods:This study consists four groups, insulin combinate metformin group, metformin group, diabetes untreated group and normal control group. Selected30cases T2DM patients to each diabetic group, include combination of insulin and metformin, metformin alone, diabetes not taking antidiabetic drugs. Application metformin1500mg/d at least and at least3months prior to enroll-ment, premixed insulin is major and at least be applied3months. In addition,30cases of non-diabetic and age-matched subjects were selected as control group. All subjects’blood pressure must be below150/90mmHg. Hyperlipidemia patients allow taking statins and fibrates lipid lowering agents, not taking probucol and other antioxidant drugs.All selected population need to required low-fat diet before blood sampling and at least fasting8hours,rugular taking hypoglycemic,lipid lowering and anti-hyper-tensive drugs.Measure the blood pressure,height,weight,body temperature nad other indicators,the normal temperature person collected fasting blood to test liver and kidney function,lipid,HbAlc and other indicators.Using enzyme-linked immuno-sorbent assay to determin the content of the blood8-iso-PGF2α, All data analyzed by SPSS17.0software.Results:Compared with the normal control group, general status, gender, age and BMI were similar, there were no significant differences among the four groups(the normal control group and three diabetic groups)(P>0.05). The diabetes duration of the three diabetic groups, the duration of hypertension, hyperlipidemia, coronary heart disease and smoking was no significant difference among the four groups(P>0.05), moreover, there were no significant difference among the group of patients with antihypertensive drugs and lipid lowering drugs(P>0.05). About the index of liver function (AST, ALT, ALK and TBiL) there were no significant difference among the four groups(P>0.05). Compared with the normal control group, the plasma FPG and serum HbAlc of the three diabetic group were significant higher(P<0.05), but there were no significant difference between each diabetic groups. Among the GFR of the four groups, there were no significant difference (P>0.05), there was no significant difference between the24h urine albumin excretion of each diabetes group (P>0.05), but significantly higher than the normal control group (P<0.05). TC, TG and LDL were no significant difference among the four groups(p>0.05), but the HDL level of the three diabetic group decreased significantly(P<0.05). Compared the serum Cr of each group, the untreated group was the highest, the metformin group was higher, and the combination insulin and metformin group and the normal control group were lower than the other two groups, there were no significant difference between the combination treatment group and the normal control group (P>0.05),but among the other group there were no significant difference(P<0.05).Compared the uric acid(UA) of each group, the untreated group was the highest, the combination treatment group and the metformin group were higher than the normal control group, there were no significant difference between the combination treatment group and the metformin group(P>0.05), however, when compared the combination treatment group and the other two group, there were significant difference(P<0.05); the UA between metformin only group and normal control group were significant difference(P<0.05) but with untreatment diabetes group were no significant difference(P>0.05),there were significant difference between untreatment diabetes group and normal control group(P>0.05)。 Compared the serum8-iso-PGF2a and hs-CRP of each group, combination insulin and metform and metformin only treatment groups had decreased8-iso-PGF2a and hs-CRP significantly(P<0.05), the8-iso-PGF2a and hs-CRP of combination treatment group was similar to the normal control group, but the8-iso-PGF2a and hs-CRP of the metformin group were higher than normal control group,8-iso-PGF2α and hs-CRP of the untreated group was the highest, P>0.05only between the combinaton treatment group and the normal control group, there were significant difference (P<0.05) among the groups.Conclusions:1).Insulin and metformin combination treatment could significantly reduced serum8-iso-PGF2a and hs-CRP, and this could reduce the level of oxidative stress and inflammatory in diabetic patients, thereby delaying the occurrence and development of diabetic complications;2). Insulin and metformin combination treatment group had the lowest serum Cr, and suggested that insulin and metformin conbination treatment protect kidney from damage;3). Insulin and metformin combination and metformin alone treatment can reduce uric acid levels to a certain extent in daibetic patients. |
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