r-n-jРоссийский неврологический журналRussian neurological journal2658-79472686-7192МИА10.30629/2658-7947-2020-25-5-29-35r-n-j-119Research ArticleИССЛЕДОВАНИЯ И КЛИНИЧЕСКИЕ НАБЛЮДЕНИЯCLINICAL RESEARCHES AND CASE REPORTSСахарный диабет 2-го типа у пациентов с острым ишемическим инсультом ассоциируется со снижением уровня глутатиона в плазме кровиType 2 diabetes mellitus in patients with acute ischemiс stroke is associated with a decrease in plasma glutathione levelshttps://orcid.org/0000-0002-7682-6672МаксимоваМ. Ю.MaksimovaM. Yu.ncnmaximova@mail.ruhttps://orcid.org/0000-0002-2424-6115ИвановА. В.IvanovA. V.

Department of Molecular and Cell Pathophysiology

Moscow

ivanov_av82@mail.ruhttps://orcid.org/0000-0002-4119-7175НикифороваК. А.NikiforovaK. A.

Department of Molecular and Cell Pathophysiology

Moscow

nikiforovaksenya@gmail.comhttps://orcid.org/0000-0003-0008-290XОхтоваФ. Р.OchtovaF. R.

Department of Nervous Diseases 

Moscow

f-okhtova@mail.ruhttps://orcid.org/0000-0002-1405-5235СуановаЕ. Т.SuanovaE. T.

Department of Nervous Diseases 

Moscow

ekaterina.souanova@gmail.comhttps://orcid.org/0000-0001-9371-6494ВирюсЭ. Д.VirusE. D.

Department of Molecular and Cell Pathophysiology

Moscow

edwardvirus@yandex.ruЗиминаИ. С.ZiminaI. S.

Department of Molecular and Cell Pathophysiology

Moscow

allakiwi@gmail.comhttps://orcid.org/0000-0002-6338-0392ПирадовМ. А.PiradovM. A.dir@neurology.ruhttps://orcid.org/0000-0001-8077-2905КубатиевА. А.KubatievA. A.

Department of Molecular and Cell Pathophysiology

Moscow

niiopp@mail.ruФедеральное государственное бюджетное научное учреждение «Научный центр неврологии»РоссияResearch Center of NeurologyRussian FederationФедеральное государственное бюджетное учреждение «Научно-исследовательский институт общей патологии и патофизиологии»РоссияFederal State Budgetary Scientific Institution «Institute of General Pathology and Pathophysiology»Russian FederationФедеральное государственное бюджетное образовательное учреждение высшего образования «Московский государственный медико-стоматологический университет имени А.И. Евдокимова» Минздрава РоссииРоссияMoscow State Medical and Dental UniversityRussian Federation2020161220202552935Copyright © Максимова М.Ю., Иванов А.В., Никифорова К.А., Охтова Ф.Р., Суанова Е.Т., Вирюс Э.Д., Зимина И.С., Пирадов М.А., Кубатиев А.А., 20202020Максимова М.Ю., Иванов А.В., Никифорова К.А., Охтова Ф.Р., Суанова Е.Т., Вирюс Э.Д., Зимина И.С., Пирадов М.А., Кубатиев А.А.Maksimova M.Y., Ivanov A.V., Nikiforova K.A., Ochtova F.R., Suanova E.T., Virus E.D., Zimina I.S., Piradov M.A., Kubatiev A.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.r-n-j.com/jour/article/view/119

Ишемический инсульт (ИИ) и сахарный диабет (СД) 2-го типа являются факторами, влияющими на гомеостаз низкомолекулярных аминотиолов (цистеина, гомоцистеина, глутатиона). Ранее было показано, что ИИ приводит к снижению уровня восстановленных форм аминотиолов, однако остается неясным, оказывает ли СД 2-го типа влияние на них.

Цель работы

Цель работы: уточнить особенности гомеостаза аминотиолов у пациентов с СД 2-го типа в остром периоде ИИ.

Материал и методы

Материал и методы. Обследовано 76 пациентов с первичным ИИ в бассейне средней мозговой артерии в первые 10–24 ч с момента развития неврологической симптоматики. В I группу вошли 15 пациентов с ИИ и СД 2-го типа; во II группу — 61 пациент с ИИ и реактивной (стрессовой) гипергликемией. Общий уровень, восстановленные формы и редокс-статус аминотиолов в плазме крови определяли при поступлении пациентов в стационар.

Результаты

Результаты. У пациентов с ИИ и СД 2-го типа по сравнению с пациентами с ИИ и стрессовой гипергликемией наблюдалось снижение уровня общего глутатиона (1,27 против 1,65 мкМ, р = 0,021), а также его восстановленной формы (0,03 против 0,04 мкМ, р = 0,007). Для пациентов с СД 2-го типа, имеющих пониженный редокс-статус гомоцистеина (0,65–1,2%) и глутатиона (0,7–2,0%), было характерно снижение уровня общего глутатиона (р = 0,02; p = 0,03).

Заключение

Заключение. СД 2-го типа в остром периоде ИИ ассоциируется со снижением уровня общего глутатиона. Вероятно, что СД 2-го типа характеризуется особой взаимосвязью между процессами метаболизма гомоцистеина, глутатиона и глюкозы. Поиск гомоцистеин-зависимых подходов к коррекции метаболизма глутатиона при СД 2-го типа может представлять определенный интерес при разработке дополнительных направлений терапии ИИ.

Ischemic stroke (IS) and type 2 diabetes mellitus are factors that affect the homeostasis of low-molecularweight aminothiols (cysteine, homocysteine, glutathione etc.). It has already been shown that IS in the acute period led to a decrease a level of reduced forms of aminothiols, but it is not clear whether type 2 diabetes mellitus has a noticeable effect there.

Objective

Objective: to reveal the features of homeostasis of aminothiols in patients with type 2 diabetes mellitus in acute IS.

Material and methods

Material and methods. The study involved 76 patients with primary middle cerebral artery IS in the first 10–24 hours after development of neurological symptoms. Group 1 included 15 patients with IS and type 2 diabetes mellitus, group 2 — 61 patients with IS and stress hyperglycemia. Their total plasma levels of cysteine, homocysteine, and glutathione, their reduced forms, and redox status were determined at admission (in the first 24 hours after IS).

Results

Results. There was a decrease in the level of total glutathione level (1.27 vs. 1.65 μM, p = 0.021), as well as its reduced form (0.03 vs. 0.04 μM, p = 0.007) in patients with IS and type 2 diabetes mellitus. Patients with type 2 diabetes mellitus who had a low redox status of homocysteine (0.65–1.2%) and glutathione (0.7–2.0%) were also characterized by a decrease in total glutathione level (p = 0.02; p = 0.03).

Conclusion

Conclusion. Thus, type 2 diabetes mellitus is associated with a decrease in the level of total glutathione in acute IS. Probably, type 2 diabetes mellitus is characterized by a particular relationship between the metabolism of homocysteine, glutathione and glucose. Therefore, the search for homocysteine-dependent approaches to correct glutathione metabolism in type 2 diabetes mellitus may be of interest as an adjuvant therapy for IS.

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The authors declare that there are no conflicts of interest present.