| Summary: | 碩士 === 國立中興大學 === 食品科學系 === 92 === Objectives: Diabetes, which has become an epidemic in the 21st century, is known to have high mortality rate and can lead to various chronic diseases. In addition to elevated oxidative stress, diabetics may also have higher plasma homomcysteine (Hcy) levels, but the evidence is inconsistent. Because both oxidative stress and Hcy are possible risk factors of atherosclerotic vascular diseases, we determined the relationships of oxidative stress and Hcy with glycated hemoglobin (HbA1c) in the diabetics. In addition, we determined plasma total Hcy (tHcy) and free Hcy (fHcy) because fHcy has been shown to be a more sensitive marker for ischemic stroke and cardiovascular disease.
Methods and design: We conducted a cross-sectional observation study by measuring plasma levels of HbA1c, Hcy, malodiadehyde (MDA, a marker of lipid peroxidation) and C-reactive protein (CRP, a marker of inflammation) in 136 Type2 diabetics (mean age 63.8) recruited from Taichung area in comparison with 110 healthy controls (mean age 60.1) from the same area. In addition, we measured plasma total antioxidant activity (oxygen-radical absorbance capacity, ORAC), which has not been studied in diabetes.
Results：The diabetics had significantly higher plasma levels of fHcy (P＜0.050) and MDA (P＜0.001) but had significantly lower values of ORAC (P＜0.0001) than the healthy controls. However, the tHcy level was not significantly different. When all subjects were combined (136 diabetics plus 110 controls), we observed significantly positive correlations for HbA1c vs. fHcy (r＝0.20；P＜0.05) and HbA1c vs. CRP (r＝0.23；P＜0.001) but a negative correlation for HbA1c vs. ORAC (r＝－0.48；P＜0.0001). Logistic regression analysis showed that age, diabetes and HbA1C affected ORAC concentration. As the age increased by 1 year, the odds ratio of ORAC greater than 1.5 units was 0.94 times that of ORAC smaller than 1.5 units.（P＝0.012）.In addition , As the HbA1C increased,by 1﹪the odds ratio of ORAC greater than 1.5 units was 0.61 times that of ORAC smaller than 1.5 units.（P＝0.0003）.It means the higher the age and HbA1c, the lower ORAC.
Conclusions：The present study demonstrates that fHcy is a more sensitive marker than tHcy for diabetes. The diabetics have increased oxidative stress, as indicated by elevated HbA1c levels and lowered ORAC value in the plasma. The combination of elevated fHcy and oxidative stress in the diabetics may predispose the patients to various vascular diseases.The results suggest that the diabetics’ patients should consume more antioxidate food to elevate plasma ORAC.
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