糖耐量水平、胰岛素抵抗与血清可溶性CD40配体的相关性

Correlation of serum soluble CD40 ligand and Glucose Tolerance along with Insulin Resistance

目的:对比不同糖耐量水平的患者外周血清中可溶性CD40配体(sCD40L)的水平,并探讨其与糖耐量水平、胰岛素抵抗指数(IR)的相关性。方法:筛选107行例糖耐量检测的患者,行葡萄糖耐量试验(OGTT)、胰岛素释放试验(InsRT),根据OGTT结果将患者分为3组:糖耐量正常组(NGT)、糖耐量异常组(IGT)、2型糖尿病组(T2DM),并收集血压、体质量指数(BMI)、低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)等指标,根据OGTT-InsRT结果计算IR,酶联免疫吸附法测外周血清中可溶性CD40配体水平。结果:13组患者在年龄、性别、收缩压(SBP)、舒张压(DBP)、BMI、LDL-C、TG等指标上均无明显统计学差异,具有较好可比性;23组患者之间sCD40L水平逐渐升高,组间比较有明显差异(P<0.01);3血清sCD40L水平与口服葡萄糖120min血糖水平,IR水平均呈正相关关系(P<0.05)。结论:高血糖、胰岛素抵抗可能触发炎症反应,导致sCD40L水平升高,糖尿病抗炎治疗有必要。

Objective： By comparing the levels of sCD40L of the patients with different degree of glucose tolerance to investigate the correlation of sCD40L and the glucose tolerance , insulin resistance. Methods： 107 patients were selected and divided into NGT, IGT and T2DM groups according to their OGTT result. Blood pressure, body mass index （BMI）, low density lipoprotein cholesterol （LDL-c） and triglyceride （TG） were determined. Insulin resistance was calculated according to the result of oral glucose tolerance test and insulin release test. Contents of sCD40L in serum were measured by Chemiluminescent enzyme-linked immunosorbent assay. Result：（1）There was no significant difference in the age, gender, systolic blood pressure, diastolic blood pressure, BMI, LDL-c, and TG index between three groups; （2） The sCD40L levels gradually increased from NGT to T2DM groups （P〈0. 01）; （3）There was a positive correlation between sCD40L and OGTT120min glucose（r=0.63, P〈0.05） and between sCD40L and IR （r= 0. 71, P〈0.01）. Conclusion： IR and high concentration of blood glucose may tead to inflammation and result in high level of sCD40L, and anti- inflammation therapy may be needed in DM therapy.