2型糖尿病患者红细胞变形能力改变与RBC能量代谢相关

基础医学与临床 ›› 2021, Vol. 41 ›› Issue (2): 245-249.

2型糖尿病患者红细胞变形能力改变与RBC能量代谢相关

孙明玥¹, 李旭妍¹, 萨如拉², 李晶晶², 梁浩³, 闫朝丽^2*, 苏燕^1*

1.包头医学院生物化学与分子生物学教研室, 内蒙古包头 014000;
2.内蒙古医科大学第一附属医院内分泌科,内蒙古呼和浩特 010000;
3.包头医学院 2017级临床医学专业本科13班, 内蒙古包头 014000

收稿日期:2020-04-25 修回日期:2020-06-28 出版日期:2021-02-05 发布日期:2021-01-19
通讯作者: ^*synmg@126.com;aliceyzl@126.com
基金资助:
国家自然科学基金(81860029);内蒙古自然科学基金(2016MS0801);内蒙古自治区卫生和计划生育委员会科研计划(201701090);内蒙古自治区研究生科研创新资助项目(S2018112036Z)

Changes in erythrocyte deformability in patients with T2DM are associated with RBC energy metabolism

SUN Ming-yue¹, LI Xu-yan¹, SA Ru-la², LI Jing-jing², LIANG Hao³, YAN Zhao-li^2*, SU Yan^1*

1. Department of Biochemistry and Molecular Biology, Baotou Medical College, Baotou 014000;
2. Department of Endocrinology, the First Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010000;
3. Class 13, Clinical Medicine 2017, Baotou Medical College, Baotou 014000, China

Received:2020-04-25 Revised:2020-06-28 Online:2021-02-05 Published:2021-01-19
Contact: ^*synmg@126.com;aliceyzl@126.com

摘要/Abstract

摘要： 目的探讨2型糖尿病(T2DM)患者红细胞(RBC)变形能力与RBC能量代谢是否相关。方法选取40~70岁的80例T2DM患者及50名健康体检者。检测血液样本的血常规、血流变及血液生化等;此外,检测RBC的三磷酸腺苷(ATP)含量及己糖激酶(HK)和丙酮酸激酶(PK)活性检测。结果 T2DM组BMI值、DBP、SBP对比对照组增高(P＜0.05);T2DM组RBC变形指数(TK)、刚性指数(IR)、RBC分布宽度(RDW)及RBC平均体积(MCV)均高于对照组(P＜0.05);T2DM组RBC内ATP含量、PK活性高于对照组(P＜0.05),而HK活性低于对照组(P＜0.05)。T2DM组的TK与ATP含量和HK活性呈负相关,与HbA1c呈正相关;IR与 HK和PK值呈负相关,与HbA1c呈正相关(P＜0.05)。结论糖尿病患者RCD受损与HbA1c密切相关,RBC能量代谢对维持RCD起重要作用;糖尿病患者RBC内ATP产量增加,PK活性增高,能量代谢反应旺盛,但这并没有改善由于高糖引起的RCD降低状态。

关键词: 2型糖尿病, 红细胞, 能量代谢, 糖酵解关键酶, 红细胞变形能力

Abstract: Objective To investigate the relationship between erythrocyte (RBC) deformability and RBC energy metabolism in patients with type 2 diabetes mellitus (T2DM). Methods Totally 80 T2DM and 50 controls with age of 40 to 70 years were selected. Rough hematology laboratory test, ATP content, Hexokinase (HK) and Pyruvate kinase (PK) activity were detected.Results BMI, DBP and SBP of patients with T2DM were higher than those of control group (P＜0.05). T2DM of RBC deformation index (TK), rigidity index(IR), RBC distribution width (RDW) and average RBC volume (MCV) were higher than that of control group (P＜0.05); The content of ATP and PK activity in RBC of T2DM group were higher than that of control group (P＜0.05), while the activity of HK was lower than that of control group(P＜0.05). In the T2DM, TK was negatively correlated with ATP content and HK activity, and positively correlated with HbA1c. IR was negatively correlated with HK and PK values, and positively correlated with HbA1c (P＜0.05). Compared with Group A, the TK value of Group C increased (P＜0.05) in the HbA1c group. Compared with Group A, Group C had higher ATP, PK and HK (P＜0.05). Compared with Group A, ROS in Group C increased (P＜0.05). Results RCD damage in diabetic patients is closely related to HbA1c, and RBC energy metabolism plays an important role in maintaining RCD. In diabetic patients, ATP production in RBC increased, PK activity increased, and energy metabolism was vigorous, but this did not improve the reduced RCD status caused by high glucose. Conclusions The energy metabolism of erythrocytes in diabetic patients was more vigorous and is closely related to the decrease of RCD. RCD reduction is a risk factor for diabetic microangiopathy, so monitoring erythrocytes energy metabolism may provide a new basis for monitoring the progress of clinical diabetes patients and support clinical diagnosis and treatment.

Key words: type 2 diabetes mellitus, red blood cells, energy metabolism, glycolytic key enzyme, red cell deformability

中图分类号:

Q592.1

孙明玥, 李旭妍, 萨如拉, 李晶晶, 梁浩, 闫朝丽, 苏燕. 2型糖尿病患者红细胞变形能力改变与RBC能量代谢相关[J]. 基础医学与临床, 2021, 41(2): 245-249.

SUN Ming-yue, LI Xu-yan, SA Ru-la, LI Jing-jing, LIANG Hao, YAN Zhao-li, SU Yan. Changes in erythrocyte deformability in patients with T2DM are associated with RBC energy metabolism[J]. Basic & Clinical Medicine, 2021, 41(2): 245-249.

参考文献

[1] 中国2型糖尿病防治指南(2017年版)[J]. 中国实用内科杂志,2018,38:292-344.
[2] Levin S, Korenstein R.Membrane fluctuations in erythrocytes are linked to NonindePendent dynamic assembly of the membrane skeleton[J]. Bio Phys J, 1991, 60: 733-737.
[3] van Wick R,van Soling WW. The energy-less red blood cell is lost: erythrocyte enzyme abnormalities of electrolysis[J]. Blood, 2005, 106: 4034-4042.
[4] Bono N, Kuwaiti M,Guitar S. Alteration of electrolytic intermediary metabolism in erythrocytes during diabetic acidosis and its recovery phase[J]. Diabetes, 1981, 30: 346-353.
[5] Homeschooling H. Microbiological of erythrocytes, blood viscosity, and the distribution of blood flow in the articulation[J]. Int Rev Physio, 1976,9:1-62.
[6] Tomaiuolo G. Biomechanical properties of red blood cells in health and disease towards microfluidics[J]. Biomicrofluidics, 2014,8:051501.doi:10.1063/1.4895755.
[7] Symeonidis A, Athanassiou G, Psiroyannis A,et al.Impairment of erythrocyte viscoelasticity is correlated withlevels of glycosylated haemoglobin in diabetic patients[J]. Clin Lab Haematol,2001,23:103-109.
[8] Nanak M, Nanak T, Amazon S. Adenosine triPhos-Phate and maintenance of shaPe of the human red cells[J]. Nature, 1960,187:945-946.
[9] Stevens VJ, Vlassara H, Abati A, et al. Nonenzy-matic glycosylation of hemoglobin[J]. J Biol Chem, 1977,252:2998-3002.
[10] McDonald MJ, ShaPiro R, Bleichman M,et al. Glycosylated minor comPonents of human adult hemoglobin. Purification, identification, and Partial structural analysis[J]. J Biol Chem, 1978,253:2327-2332.
[11] Besch W, Blücher H, Bettin D, et al. Erythrocyte sodium-lithium countertransport, adenosine triphosphatase activity and sodium-potassium fluxes in insulin-dependent diabetes[J]. Int J Clin Lab Res, 1995, 25: 104-109.
[12] Mali AV,Bhise SS,Hegde MV.Altered erythrocyte glycolytic enzyme activities in type-Ⅱ diabetes[J]. Indian J Clin Biochem, 2016,31:321-325.

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