摘要
目的分析不同遗传背景的2型糖尿病病人血清肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）和高敏C反应蛋白（hsCRP）水平与胰岛素分泌的相关性。方法选取不同遗传背景的2型糖尿病病人或一级亲属共90例作为研究对象,其中初诊2型糖尿病有家族史（DH＋）30例为DH＋组,初诊2型糖尿病无家族史（DH-）30例为DH-组,糖耐量正常有2型糖尿病家族史（NH＋）30例为NH＋组;同期选择来我院健康体检并排除遗传史者（NH-）30例作为对照。采集各组受检者血清,酶联免疫分析法测定各组TNF-α、IL-6及hsCRP水平;氧化酶法测定各组空腹血糖浓度;精氨酸刺激试验测定各组第一时相胰岛素（INS）分泌量（FP-INS）,并计算INS抵抗指数（HOMA-IR）。结果 DH＋与DH-组血清TNF-α、IL-6、hsCRP水平及HOMA-IR较NH＋组和NH-组均明显升高,差异有显著性（F=26.9～33.9,P〈0.01）;DH＋组和NH＋组FP-INS水平较NH-组明显下降,差异有显著性（F=4.9,P〈0.01）。FP-INS、HOMA-IR与家族遗传史和相关炎症因子水平显著相关（r=-0.204～0.436,P〈0.05）。逐步回步分析显示,FP-INS与家族史和hsCRP有关,HOMA-IR与IL-6、hsCRP有关。结论血清TNF-α、IL-6、hsCRP和遗传史与2型糖尿病病人的胰岛素分泌功能异常关系密切;胰岛功能损伤和IR在不同遗传背景的2型糖尿病的病程早期所占主导地位可能不同。
Objective To analyze the relationship between plasma TNF-α,IL-6,hsCRP and insulin secretion in type 2diabetes mellitus（T2DM）with different genetic background. Methods Ninety subjects with T2 DM or their first-degree relatives were enrolled in this study-30 cases of newly-diagnosed T2 DM with diabetes family history（DFH）（DH＋group）,30 of newly-diagnosed T2 DM without DFH（DH-group）and 30 of normal glucose tolerance（NGT）with DFH（NH＋group）-and in the corresponding period,30 health subjects with exclusion of genetic history（NH-group）were selected to be saved as controls.Serum TNF-α,IL-6,and hsCRP were determined using ELISA;fasting blood glucose concentration（FBGC）was measured with oxidase method;and employing ECLIA,the serum insulin（INS）of first-phase secretion level（FP-INS）,after intravenous arginine stimulation test was determined,and INS resistance index（HOMA-IR）calculated. Results In DH＋and DH-groups,the levels of TNF-α,IL-6,hsCRP and HOMA-IR were notably higher than that in NH＋and NH-groups（F=26.9-33.9,P〈0.01）.In DH＋and NH＋groups,the level of FP-INS was lower than that in NH-group（F=4.9,P〈0.01）.There was a positive correlation between FP-INS,HOMA-IR,family history and inflammatory factors（r=-0.204-0.436,P〈0.05）.Stepwise regression analysis showed that there was a quantitative relationship between FP-INS and family history,hsCRP,and HOMA-IR with IL-6and hsCRP. Conclusion There is a close relationship between serum TNF-α,IL-6,hsCRP and genetic history as well as abnormal insulin secretion in patients with type 2diabetes.The dominant position of islet dysfunction and IR may be different in the early stage of the disease in different genetic backgrounds.
出处
《青岛大学医学院学报》
CAS
2016年第4期399-401,共3页
Acta Academiae Medicinae Qingdao Universitatis
基金
青岛市科技局科技基金资助项目(12-4-1-36-nsh)
