血浆IL-18和Hcy及hsCRP与2型糖尿病大血管并发症的相关性研究

The relationship among interleukin-18, homocysteine, high-sensitivity C-reactive protein and macrovascular complication in type 2 diabetes

目的研究血浆白细胞介素18（IL-18）、同型半胱氨酸（Hcy）、超敏C反应蛋白（hsCRP）与2型糖尿病大血管并发症的关系。方法收集本院住院的2型糖尿病患者（50例）血浆标本为T2DM组,以健康志愿者血浆标本（20例）作为正常对照组。糖尿病患者又分为大血管并发症组（30例）及非大血管并发症组（20例）。采用ELISA法测定IL-18,高效液相色谱法测定Hcy。IL-18与Hcy、hsCRP的相关性用简单相关分析,用多元逐步线性回归分析血浆IL-18的影响因素。结果T2DM组较正常对照组血浆IL-18、Hcy、hsCRP明显升高;大血管病变组血浆IL-18、Hcy、hsCRP与非大血管病变组、正常对照组血浆IL-18、Hcy、hsCRP比较,差异有统计学意义（P〈0.05）;IL-18与Hcy、年龄、hsCRP、FPG、2hPG呈正相关;T2DM组为整体,IL-18为因变量,Hcy、hsCRP等14个因素为自变量,进行多元逐步线性回归分析,最后Hcy、FPG、hsCRP进入回归方程。结论IL-18、Hcy、hsCRP与2型糖尿病大血管并发症有关,IL-18和Hcy、hsCRP具有相关性。

Objective To study the relationship among interleukin-18, homocysteine, high-sensitivity C-reactive protein and macrovascular complication in type 2 diabetes. Methods Seventy specimens of plasma were collected from 50 patients with type 2 diabetes, and 20 matched healthy subjects in Tongji hospital, from June to December 2005. Fifty cases of type 2 diabetes were divided into macrovascular complications subgroup （30 cases） and non macrovascular complications subgroup （20 cases）. Plasma concentrations of Interleukin-18 were measured in EDTA-anti -coagulanted plasma using ELISA , and Hcy was detected with high-performance liquid chromatography. The relationship among interleukin-18, homocysteine, high-sensitivity C- reactive protein were analyzed by Bivariate Correlations analysis. The factors related to interleukin-18 in type 2 diabetes were analyzed by multiple stepwise Linear Regression analysis. Results Plasma IL-18, Hcy, hsCRP concentrations were significantly higher in type 2 diabetic patients than that in age -matched control subjects. Plasma IL-18, Hcy, hsCRP concentrations were significantly higher in macrovascular complications subgroup, compared with non macrovascular complica- tions subgroup and health control subjects. Multiple stepwise Linear Regression analysis showed that plasma Hcy, FPG and hsCRP were independently factors and significantly correlated with Plasma IL-18. Conclusion Interleukin-18, Hcy and hsCRP might be important risk factors for macrovascular complications in type 2 diabetes , and plasma IL-18 positively correlated with plasma Hcy and hsCRP.