高壓氧治療對第二型糖尿病患者血清中細胞激素的影響

Effects of hyperbaric oxygen therapy on serum cytokines in patients with type 2 diabetes mellitus

陳識仁(Shih-Jen Chen)

指導教授 ： 周明智

中山醫學大學/醫學院/醫學研究所/碩士(2007年)

https://doi.org/10.6834/CSMU.2007.00007

摘要

背景：利用高壓氧氣治療糖尿病併發足部潰瘍曾多次被報導。然而，高壓氧治療是否對“與傷口癒合有關的生長因子或發炎媒介物”有影響，至今仍未全盤了解。
目的：本篇研究主要針對高壓氧治療是否對第二型糖尿病患者血清中細胞激素，一氧化氮(NO)及insulin-like growth factors(IGFs)的濃度有影響。
方法：從2002年一月到2003年十二月，我們共收集三十一位第二型糖尿病患者和二十九位健康個體的血清加以分析。每個個體皆接受連續三次高壓氧治療。採集血液的時間點分別在高壓氧治療前、第一次治療後及第三次治療後。
結果：在高壓氧治療前，兩組比較起來，糖尿病組病人的body mass index(BMI)及血清中HbA1c濃度顯著較高，而血清中IGF-I顯著較低(one-way ANOVA, p<0.05)。在調整年齡、性別及BMI因素之後，兩組個案的血清中胰島素(insulin)、生長激素(GH)、IGF-II、IGF-binding protein-1(IGFBP-1)、IGFBP-3、leptin、interleukin-8(IL-8)及NO的濃度並不受高壓氧治療次數的影響(repeated-measures ANOVA)。在對照組個案中，高壓氧治療前後血清胰島素濃度的變化對血清leptin濃度變化而言是正向預測值(positive predictors)。在糖尿病組個案中，高壓氧治療前後血清胰島素濃度的變化對血清NO濃度變化而言亦是正向預測值(positive predictors)。
結論：短期的高壓氧治療對血清胰島素、IGF、leptin、IL-8和NO的濃度沒有影響。

關鍵字

高壓氧治療 ； 第二型糖尿病 ； 細胞介素-8 ； 一氧化氮 ； 瘦體素 ； 類胰島生長因子

並列摘要

Background: The potential benefits of hyperbaric oxygen therapy (HBOT) have been reported in diabetic patients with foot ulcers. However, the roles of HBOT on wound healing-associated growth factors and inflammatory mediators are not completely understood in diabetes mellitus (DM).
Objectives: The aim of this study was to investigate the effects of HBOT on circulating cytokines, NO, and insulin-like growth factors (IGFs) in patients with type 2 DM.
Design and methods: Serum samples were collected from patients with type 2 DM (n=31) and healthy subjects (n=29) before (baseline) and after the first and third exposure.
Results: Before HBOT, body mass index (BMI) and serum HbA1c were significantly greater, whereas serum IGF-I was significantly lower in diabetic patients compared to healthy subjects (one-way ANOVA, p<0.05). After adjusting for age, gender, and BMI, serum insulin, growth hormone (GH), IGF-II, IGF-binding protein (IGFBP)-1, IGFBP-3, leptin, interleukin (IL)-8, and NO were not significantly altered by HBOT in diabetic patients and healthy subjects (repeated-measures ANOVA). Change in serum insulin (baseline to the third exposure) was a positive predictor of changes in leptin and NO in healthy subjects and diabetic patients, respectively.
Conclusions: Our results suggest that short-term HBOT may not alter the circulating insulin, IGF, leptin, IL-8, and NO levels. Further studies are needed to clarify the mechanism of HBOT-improved wound healing in diabetic patients with foot ulcers.

並列關鍵字

Hyperbaric oxygenation ； Type 2 diabetes mellitus ； interleukin-8 ； Nitric oxide ； Leptin ； Insulin-like growth factors

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