2型糖尿病一级亲属血清leptin、TNF-α、IL-6表达与胰岛素抵抗的相关性研究

Correlation of the serum levels of leptin,TNF-α and IL-6 with the insulin resistance in the first-degree relatives of type 2 diabetic family

目的研究糖尿病家系中正常糖耐量一级亲属血清瘦素(leptin)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)表达与胰岛素抵抗的相关性。方法将研究对象分为2型糖尿病(T2DM)组134例、一级亲属糖耐量正常(NFDR)组128例、正常对照(NC)组120例。每组按体质量指数(BMI)分为肥胖组(BMI≥25)和非肥胖组(BMI<25)。测定空腹血清leptin、TNF-α、IL-6、血清总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDLC)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖、空腹胰岛素并计算胰岛素抵抗指数(HOMA-IR)。结果 NC、NFDR、T2DM组的HOMA-IR依次增高;TG在NC、NFDR、T2DM组中依次递增;HDL-C依次递减(P<0.05),T2DM、NFDR、NC各组中肥胖组leptin、TNF-α、IL-6均高于非肥胖组(P<0.05)。leptin、TNF-α、IL-6在T2DM组、NFDR组、NC组的肥胖组中依次递减(P<0.05)。各组非肥胖组之间差异无显著性(P>0.05)。NFDR组HOMA-IR与BMI、TG、leptin、TNF-α、IL-6呈正相关(P<0.05)。结论 T2DM家系正常糖耐量一级亲属胰岛素抵抗与血清leptin、TNF-α、IL-6正相关,肥胖组中尤为显著。

Objective To investigate the correlation of the serum levels of leptin,tumor necrosis factor-α(TNF-α) and interleukin-6(IL-6) with the insulin resistance in the first-degree relatives with normal glucose tolerance of type 2 diabetic family.Methods The subjects were divided into type 2 diabetes mellitus group(T2DM group,134 cases),normal glucose tolerance first-degree relatives group(NFDR group,128 cases),normal control group(NC group,120 cases).According to body mass index(BMI),each group was divided into obese subgroup(BMI≥25) and non-obese subgroup(BMI<25).Fasting serum levels of leptin,TNF-α,IL-6,total cholesterol(TC),triglyceride(TG),high density lipoprotein-cholesterol(HDL),lower density lipoprotein-cholesterol(LDL),fasting blood glucose(FBG) and insulin were detected,and HOMA-IR was analyzed.Results The level of HOMA-IR and TG in NC,NFDR and T2DM groups was increased in turn,while the level of HDL-C was decreased in turn(P<0.05).In the obese subgroup of T2DM,NFDR and NC groups,the levels of leptin,TNF-α and IL-6 were declined in turn(P<0.05),and the levels in the obese subgroups were all higher than those in the non-obese subgroups(P<0.05).The level of HOMA-IR of NFDR group was positively correlated with BMI,TG,leptin,TNF-α and IL-6(P<0.05).Conclusions The insulin resistance of the firstdegree relatives with normal glucose tolerance in diabetic family is positively correlated with the serum levels of leptin,TNF-α,IL-6,which is particularly significant in the obese subgroup.