不同糖耐量人群血浆IL-18水平与胰岛素抵抗的相关性

Relationship between Plasma Interleukin-18 Levels and Insulin Resistance in Patients with Different Glucose Tolerance

目的:探讨不同糖耐量人群血浆中白细胞介素-18(IL-18)水平变化与胰岛素抵抗的相关性。方法:收集2型糖尿病(T2DM,n=30)组、糖耐量减低(IGT,n=30)组及糖耐量正常(NGT,n=28)组相关临床资料,ELISA法测定血浆中IL-18水平,以胰岛素抵抗指数(HOMA-IR)作为估计胰岛素抵抗(IR)的指标,HOMA-IR分别与各代谢指标做Pearson相关分析,并对影响HOMA-IR的危险因素进行多元逐步回归分析。结果:T2DM及IGT组体重指数(BMI)、腰围、三酯甘油(TG)、HOMA-IR及IL-18等指标均显著高于NGT组,差异有统计学意义(P<0.01)。Pearson相关分析显示HOMA-IR与IL-18及BMI呈显著正相关(r分别为0.571、0.423,P<0.01),调整BMI后IL-18与HOMA-IR独立相关(r=0.50,P<0.01)。多元逐步回归分析,4个变量进入回归模型(P<0.05),分别为IL-18(Beta值:0.498)、BMI(Beta值:0.358)、TG(Beta值:0.353)、TC(Beta值:0.298)。结论:IL-18在IGT阶段已有显著增高,可能通过IR而参与了T2DM的发生和发展。

Objective： To investigate the relationship between plasma interleukin-18 （IL-18） levels and insulin resistance （IR） in patients with different glucose tolerance. Method： Eighty-eight people were divided into 3 groups including impaired glucose tolerance group （ group IGT, n = 30） , type-2 diabetes mellitus group（ group T2DM, n = 30）and normal glucose tolerance group（ group NGT, n = 28）. Plasma IL-18 levels were measured by using ELISA. Homeostasis model assessment index of insulin resistance （HOMA-IR） was used as indicatrix reflecting IR level. Pearson＇s correlation analysis was carried out between HOMA-IR and other metabolic indexes, and multiple stepwise regression analysis was used to identify the influence of risk factors to IR. Results： Body mass index （BMI）, Waistline, trigly- erde （TG）, HOMA-IR and IL-18 were significantly higher in groups T2DM and IGT than in group NGT （P 〈0.01）. Pearson＇s correlation analysis showed significant positive correlations occurred between plasma HOMA-IR and IL-18, and between HOMA-IR and BMI （ r =0. 571 ,and r =0. 423 respectively, P 〈0.01）. Multiple stepwise regression analysis showed that IL-18, BMI, TG, and total cholesterol （TC） were independently associated with HOMA-IR, and the standard correlation coefficients were 0. 498, 0. 358, 0. 353, and 0. 298 respectively （P 〈 0.05 ）. Conclusion ： IL-18 level has increased in pre-diabetic stage, and might participate the pathogenesis and development of type 2 diabetes by affecting IR.