The relationship between oxidative stress and the levels of serum circulating adhesion molecules in patients with hyperglycemia crises.
OBJECTIVE
To investigate the relationship between oxidative stress and the levels of serum circulating adhesion molecules in patients with hyperglycemia crises.


METHODS
A total of 73 patients with diabetic ketoacidosis and nonketotic hyperglycemia were treated on a low-dose insulin protocol using intravenous infusion of insulin with the established rate of 0.1U·kg(-1)·h(-1). The patients received intravenous fluids and nutrition orally and intravenously. The levels of serum ICAM-1, E-selectin, and 8-iso-prostaglandin F(2α) (8-iso-PGF(2α)); the activities of superoxide dismutase (SOD); the total antioxidant capacity (TAC) and the contents of malondialdehyde (MDA) in 68 patients with hyperglycemia crisis on admission and after insulin therapy with resolution of hyperglycemia and ketoacidosis (72 h after resolution) were measured. Another 33 healthy individuals served as normal controls.


RESULTS
The activities of SOD and TAC at admission were lower in patients with hyperglycemia crisis than in normal controls, and the levels of MDA, 8-iso-PGF(2α), ICAM-1 and E-selectin were higher in patients with hyperglycemia crisis than in normal controls (all p<0.05). The activities of SOD and TAC in patients at resolution were significantly lower than in patients at admission and were significantly higher than in controls (p<0.05). The levels of MDA, 8-iso-PGF(2α), ICAM-1 and E-selectin in patients at resolution were markedly lower than in patients at admission (all p<0.05) and were significantly higher than in normal controls (p<0.05). There was a significant positive correlation between ICAM-1 and SOD (r=0.32, p<0.05) and between E-selectin and MDA (r=0.30, p<0.05) in patients at admission, and the level of E-selectin was positively correlated with MDA and 8-iso-PGF(2α) in patients at resolution (r=0.33, 0.36, p<0.05). In stepwise regression analysis, MDA and 8-iso-PGF(2α) showed a significant association with E-selectin, and 8-iso-PGF(2α) showed a significant association with ICAM-1.


CONCLUSIONS
The oxidative stress and the levels of serum circulating adhesion molecules are significantly changed in patients with hyperglycemia crisis. Intensive insulin therapy can attenuate the abnormity of oxidative stress and the levels of serum circulating adhesion molecules in patients with hyperglycemia crisis.
Department of Endocrinology, Zhongshan Hospital Xiamen University, Xiamen 361004, Fujian, China.
Xing-ping
XP
Shen
Juan
J
Li
Senbiao
S
Zou
Hao-jie
HJ
Wu
Yan
Y
Zhang
D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications / Q000188:drug therapy; D016883:Diabetic Ketoacidosis / Q000097:blood* / Q000209:etiology; D015237:Dinoprost / Q000031:analogs & derivatives / Q000097:blood; D004305:Dose-Response Relationship, Drug; D019040:E-Selectin / Q000097:blood* / Q000187:drug effects; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000097:blood* / Q000209:etiology; D007262:Infusions, Intravenous; D007328:Insulin / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood* / Q000187:drug effects; D008297:Male; D008315:Malondialdehyde / Q000097:blood; D008875:Middle Aged; D018384:Oxidative Stress / Q000187:drug effects / Q000502:physiology*; D016896:Treatment Outcome
D001786:Blood Glucose; D019040:E-Selectin; D007328:Insulin; D018799:Intercellular Adhesion Molecule-1; C075750:8-epi-prostaglandin F2alpha; D008315:Malondialdehyde; D015237:Dinoprost