-Original-

Improving in the Fasting, but Not the Postprandial, Glucose Level is Associated with Reduction of Plasma d-ROMs Level in Patients with Type 2 Diabetes

Makoto Ohara, Kentaro Watanabe, Tatsuya Suzuki, Ken-ichi Sekimizu, Masayuki Motoyama, Kazuhito Ishii, Keisuke Sawai, Hiroshi Nakano, Kenzo Oba and Kyoichi Mizuno

Divisions of Cardiology, Hepatology, Geriatrics, and Integrated Medicine, Department of Internal Medicine, Graduate School of Medicine, Nippon Medical School

Aims: This study aimed to evaluate the relationship between improvement of glucose metabolism and plasma levels of diacron-reactive oxygen metabolites (d-ROMs) in patients with type 2 diabetes.
Methods: As the first daily profile, the plasma levels of glucose and d-ROMs were determined on admission. Then, after treatment to lower plasma glucose levels, the second daily profile of these levels was evaluated. Fasting plasma glucose (FPG), the total area under the curve (AUC) of the daily plasma glucose profile (AUC_DP), the AUC of the postprandial plasma glucose levels (AUC_PP), the AUC of the daily plasma d-ROMs profile (AUC_d-ROMs), the coefficient of variation (CV) of plasma glucose (CV_PG), and the mean amplitude of glycemic excursions (MAGE) were calculated. The relationship between the improvement of glucose metabolism and that of oxidative stress in patients with type 2 diabetes was evaluated.
Results: The second determinations of FPG, AUC_DP, AUC_PP, MAGE, and AUC_d-ROMs were significantly lower than those of the first determinations, but no significant difference was observed in CV_PG. Linear regression analysis demonstrated significant associations between the changes in AUC_d-ROMs and the changes in both FPG and AUC_DP, whereas no significant association was observed between the change in AUC_d-ROMs and the change in AUC_PP, CV_PG, or MAGE.
Conclusions: This study has demonstrated that improvement of the FPG level, but not of the postprandial glucose level, is associated with a reduction of the plasma level of d-ROMs in patients with type 2 diabetes.

J Nippon Med Sch 2013; 80: 200-210

Keywords
oxidative stress, diacron-reactive oxygen metabolites, type 2 diabetes, daily profile of plasma glucose, and postprandial glucose

Correspondence to
Makoto Ohara, MD, Divisions of Cardiology, Hepatology, Geriatrics, and Integrated Medicine, Department of Internal Medicine, Graduate School of Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
s6018@nms.ac.jp

Received, November 9, 2012
Accepted, December 27, 2012