摘要
目的观察2型糖尿病(T2DM)及代谢综合征(MS)中肿瘤坏死因子α(TNF-α)及高敏C反应蛋白(hsCRP)的变化,并探讨其临床意义。方法选择新诊单纯T2DM患者48例,MS患者51例及健康人对照(NC)组20名,分别测定BMI、WC、WHR、血压、血脂、TNF-α及hsC-RP,行OGTT、胰岛素释放试验(IRT)。用HOMA-β评估基础胰岛素分泌功能,用糖负荷后30min血浆胰岛素及葡萄糖的净增值之比(△I_(30)/△G_(30))评估胰岛素早期分泌相,用HOMA-IR评估胰岛素的敏感性。结果直线相关分析显示BMI、WC、TG及HOMA-IR与TNF-α呈明显正相关,而△I_(30)/△G_(30)及H()MA-β与TNF-α呈明显负相关(P均<0.05)。HOMA-β在T2DM组中显著降低,而MS组则无明显改变;△I_(30)/△G_(30)在T2DM及MS组中均显著降低;HOMA-IR在两组中均显著增高(P均<0.01)。上述胰岛素分泌功能的变化TNF-α增高组较TNF--α正常组更为明显(P<0.05)。结论在T2DM及MS患者中,TNF-α不仅加重胰岛素抵抗,且对胰岛素基础分泌及糖负荷后早期分泌相也具有损害作用。
Objective To observe the changes of proinflammatory cytokines（PIC） in type 2 diabetes mellitus（T2DM） and metabolic syndrome（MS）. Methods 48 cases of newly diagnosed T2DM, 51 cases of MS and 20 cases of healthy adults（control group） were enrolled and BMI, waist circumference （WC）, waist-to-hip ratio （WHR）, blood pressure, TG, HDL-C, OGTT, insulin release test （IRT）, C-peptide release test （CRT）, TNF-a and hs-CRP were determined. In addition, HOMA-β, △I30/△G30 and HOMA-IR were calculated for the evaluation of basic and early-phase insulin secretion and insulin sensitivity respectively. Results Linear correlation analysis showed that BMI,WC,TG and HOMA-IR had obvious positive correlation with TNF-α. HOMA- β and △I30/△G30 had obvious negative correlation with TNF-α（P〈0.05）. HOMA-β was markedly lower in T2DM group only. The changes of △I30/△G30 were significantly lower in T2DM and MS groups（P〈0.001）. HOMA-IR was significantly increased in T2DM and MS groups（P〈0. 01）. However, the subgroup analysis showed that the above changes in the increased TNF-α group were more significant than in the normal TNF-α group（P〈0.05）. Conclusions In T2DM and MS, TNF-α not only enhances insulin resistance but also damages insulin secretion.
出处
《中国糖尿病杂志》
CAS
CSCD
北大核心
2010年第7期490-492,共3页
Chinese Journal of Diabetes
关键词
促炎症因子
糖尿病
2型
代谢综合征
肿瘤坏死冈子
高敏C反应蛋白
Proinflammatory cytokines
Diabetes mellitus, type 2
Metabolic syndrome
Tumor necrosis faetor
High-sensitivity C-reactive protein
