摘要
目的探讨成人隐匿性自身免疫糖尿病(LADA)血清细胞因子的特点和在西格列汀干预下的变化情况。方法(1)细胞因子基线研究:收集2010至2011年于中南大学湘雅二医院内分泌科门诊就诊的30例LADA患者作为LADA组,30例年龄、性别与之匹配者纳入健康对照组,采集空腹血清标本。(2)随机对照临床试验:将LADA组30例患者按照随机数字表法分为西格列汀+胰岛素(100 mg/d)(15例)及胰岛素组(15例),分别于0、6、12个月进行随访,采集各随访时点的一般资料、空腹和餐后2 h血浆和血清标本。(3)采用多因子检测技术测定LADA组和健康对照组各随访时点的血糖、C肽、脂联素、白介素-1受体拮抗体(IL-1RA)、瘦素、白介素-6(IL-6)和炎性蛋白-10(IP-10)等指标。各组内时间点及两组间各个时间点计量资料的比较采用重复测量数据方差分析。结果与健康对照组相比,LADA患者的血清脂联素浓度为1.11(0.99,1.28)ng/ml,IL-1RA的浓度为865.63(682.04,1044.55)pg/ml,比健康对照组高,差异有统计学意义(均P<0.05);LADA患者的血清瘦素为4832.72(1751.39,9084.29)pg/ml,低于健康对照组,差异也有统计学意义(P<0.05)。两组间的血清IL-6、IP-10水平差异无统计学意义(均P>0.05)。LADA的Leptin浓度与BMI呈正相关(r=0.535,P=0.002),与GADA滴度成负相关(r=-0.551,P=0.002)。在随访12个月时,西格列汀+胰岛素组以及胰岛素组LADA患者的IL-1RA浓度分别为602.13(527.82,768.57)、618.68(502.40,966.84)pg/ml,均较基线值的818.34(658.04,1028.12)、851.56(720.05,1239.26)pg/ml明显降低,差异均有统计学意义(P值分别为0.013和0.027);而余细胞因子在两组随访各时点均无明显变化(均P>0.05)。结论LADA存在脂肪细胞因子和抗炎因子谱的异常,但暂未发现西格列汀治疗可改善LADA的炎症状态。
Objective To investigate whether the serum cytokines in latent autoimmune diabetes in adults(LADA)patients were abnormal and whether sitagliptin could exert effects on the serum cytokines levels of LADA patients.Methods(1)There were thirty LADA patients and thirty normal subjects matched with age and sex were selected and their fasting serum were collected.(2)LADA patients were randomized to group A treated with insulin and sitagliptin(n=15)and group B treated with insulin only(n=15).The intervention lasted for 12 months and the patients were followed at the baseline,6 and 12 months seperately.Fasting and 2-hour postprandial serum samples and clinical data were collected at each point.3.Serum Adiponectin,interleukin-6(IL-6),interleukin-1 receptor antagonist(IL-1RA),inflammatory protein-10(IP-10)and leptin levels were determined by the human premixed multi-analyte kit.All the cytokines were compared between LADA patients(baseline data)and normal controls.Meanwhile,they were also monitored in the above two LADA groups at the baseline,6 month and 12 months during the follow-up.Differences between groups were analyzed using independent samples t test.Analysis of variance of repeated measurements was used to compare all the points during the following period within the two groups and between the two groups.Results(1)The serum Adiponectin[1.11(0.99,1.28)vs.0.96(0.73,1.12)ng/ml]and IL-1RA[865.63(682.04,1044.55)vs.718.63(478.39,807.89)pg/ml]levels in LADA patients were significantly higher than those in normal controls(P<0.05),whereas the serum Leptin level[4832.72(1751.39,9084.29)vs.8123.8(4844.48,14157.95)pg/ml]in LADA patients was lower than that in normal controls(P<0.05).There was no significant differences in serum IL-6 and IP-10 levels between the two groups(P>0.05).Moreover,the serum Leptin level in LADA patients was positively correlated to BMI(r=0.535,P=0.002)and was negatively correlated to GADA titers(r=-0.551,P=0.002).(2)Twelve months later,the serum IL-1RA level in insulin with sitagliptin group and insulin
作者
袁娇
赵云娟
梁慧迎
黄干
周智广
杨琳
Yuan Jiao;Zhao Yunjuan;Liang Huiying;Huang Gan;Zhou Zhiguang;Yang Lin(Department of Metabolism and Endocrinology,Key Laboratory of Diabetes Immunology,Ministry of Education,the Second Xiangya Hospital,Central South University,National Clinical Research Center for Metabolic Diseases,Changsha 410011,China;Department of Metabolism and Endocrinology,Jiangxi Provincial People′s Hospital,Nangchang 330000,China;Department of Endocrinology,the Second Affiliated Hospital of Guangzhou Medical University,Guangzhou 510000,China)
出处
《中华糖尿病杂志》
CAS
CSCD
北大核心
2020年第9期710-715,共6页
CHINESE JOURNAL OF DIABETES MELLITUS
基金
国家重点研发计划(2018YFC2001005)。
关键词
糖尿病
成人隐匿性自身免疫糖尿病
西格列汀
细胞因子
Diabetes mellitus
Latent autoimmune diabetes in adults patients
Sitagliptin
Cytokines
