血脂可以预测2型糖尿病患者的神经损伤风险
![Flow diagram of the study strategy. Participants (<i>n</i> = 169) were originally recruited for the Renoprotection in Early Diabetic Nephropathy in Pima Indians trial from 1996 to 2001. Participants were followed for 6 years to assess the trial outcome. Of the original 169 clinical trial participants, 89 were subsequently enrolled in a long-term observational study, which banked baseline serum and collected baseline clinical data (age, sex, height, weight, BMI, blood pressure, heart rate, diabetes duration, FPG, HbA<sub>1c</sub>, total cholesterol, triglycerides, GFR, urine ACR, and medication use). At a mean 10-year follow-up, all 89 participants were reexamined, and peripheral neuropathy was assessed by MNSI examination (foot ulceration, vibration, and ankle reflexes) and questionnaire. Of these, 69 participants met the eligibility criteria for this study, which included the availability of a stored serum sample 10 years prior to the neuropathy evaluation. Banked serum from 10 years prior was analyzed by mass spectrometry; 435 lipids from the 18 classes were quantitated and their abundance by chain length and saturation were analyzed. ACR, albumin creatinine ratio; ESRD, end-stage renal disease; FPG, fasting plasma glucose; GFR, glomerular filtration rate; HbA<sub>1c</sub>, glycated hemoglobin; MNSI, Michigan Neuropathy Screening Instrument; PN, peripheral neuropathy. Credit: <i>Annals of Clinical and Translational Neurology</i> (2022). DOI: 10.1002/acn3.51639 血脂可以预测2型糖尿病患者的神经损伤风险](https://scx1.b-cdn.net/csz/news/800a/2022/lipids-in-blood-predic.jpg)
在3700万美国糖尿病患者中,高达50%的人可能最终会出现神经损伤或糖尿病神经病变,这可能会带来疼痛和致残。
虽然一些药物可以减轻疼痛,但科学家们仍在继续寻找导致患者患上糖尿病的因素神经病变-找出减少有害症状风险的方法。
密歇根医学院的一项研究发现,多种脂质生物标记物与2型糖尿病患者神经病变的发展有关。
研究人员检测了来自吉拉河印第安社区近70名2型糖尿病患者的血清样本,这些患者在10年后接受了神经病变检查。他们分析了435种不同种类的脂类,脂类是由脂肪和油组成的有机化合物。
研究结果发表于临床与转化神经病学年鉴揭示参与者在糖尿病性神经病脂质变化是否反映受损能量代谢.
“我们有可能对这些进行测试脂类生物标志物在2型糖尿病患者中找出那些最有可能发生的人周围神经病变并促进对这些患者进行更集中的管理,”资深作者Eva L. Feldman说,医学博士,詹姆斯W.阿尔伯斯在密歇根大学的杰出教授和神经病学的Russell N. DeJong教授和密歇根医学新兴疗法神经网络主任。
虽然患有和未患神经病变的参与者的基本血脂图谱存在差异,但研究人员发现,在患有神经病变的人的血脂图谱中,有一种模式在一种叫做b-氧化的关键通路上显示出信号功能障碍。这一途径将脂质转化为神经能量的来源,当能量缺乏的神经受损时,就会受到损伤,导致神经病变。
“随着我们对血清之间关系的了解越来越多脂质费尔德曼说:“物种和神经病变,它将打开靶向治疗的可能性,包括药物和生活方式干预。”“我们的研究结果支持这样一个概念,即不饱和健康脂肪比高饱和脂肪更能提供神经能量。我们强烈推荐地中海式饮食,以保持健康的神经系统。”
费尔德曼还提倡锻炼,它能提高b氧化途径的效率。“坚持健康的饮食和锻炼计划是预防神经病变的关键,”她说。
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