2型糖尿病并肥胖患者血清白细胞介素-18与淋巴细胞亚群的变化

The variance of serum IL-18 level and lymphocyte subpopulations in the patients with obese diabetic

目的观察2型糖尿病（T2DM）并肥胖患者血清自细胞介素-18（IL-18）水平与淋巴细胞亚群的变化。方法64例T2DM患者按是否伴有肥胖分为糖尿病并肥胖患者31例（A组）、糖尿病不伴有肥胖33例（B组），选择同期健康体检者23例（C组），观察各组血糖（FPG）、胰岛素（FPI）、总胆固醇（TC）、甘油三酯（TG）、IL-18和外周血中T淋巴细胞亚群CD3^＋及CD4^＋、CD8^＋的变化及胰岛素敏感指数（ISI）不同。结果与C组比较，A组、B组的TC、TG、FPG、FPI水平均明显增高（P〈0．05、P〈0．01），ISI则显著降低（P〈0．01）；与B组比较，A组的血脂显著增高（P〈0．05）；与C组比较，A组、B组的CD3^＋、CD8^＋亚群细胞数、IL-18水平均显著增高（P〈0．05，P〈0．01），CD4^＋、CD4^＋／CD8^＋比值显著降低（P〈0．05）；与B组比较，A组CD3^＋、CD8^＋亚群细胞数均显著增高（P〈0．05），CD54^＋、CD4^＋／CD8^＋比值显著降低（P〈0．05）。结论T2DM患者胰岛素抵抗、脂代谢紊乱、免疫功能紊乱与肥胖有关。

Objective To observe on the variance of serum IL-18 level and lymphocyte subpopulations in the patients with obese diabetic（T2DM）. Methods The diabetic obese group contained 31 cases,the non-diabetic obese group contained 33 cases, healthy normal body weight group contained 23 cases, the blood glucose （ FPG）, insulin （FPI） ,blood total cholesterol （TC）, triglyceride （TG）, IL-18 and the cell population of lymphocyte subpopulations CD3^＋ and CD4^＋ , CD8^＋ in peripheral blood were determined, the insulin sensitivity index were calcnlated. Results Compared with the healthy normal body weight group, the blood fat, FPG, FPI, IL-18 of T2DM patients significantly increased,there were significant statistical difference （ P 〈 0. 05 or P 〈 0. 01 ）. The ISI significantly decreased （ P 〈 0. 01 ）. Compared with the non-diabetic obese group,the blood fat and IL-18 of T2DM patients significantly increased （P 〈0. 05）. Compared with the diabetic obese group, the subpopulations cell population of CD3^＋ ,CD4^＋ ,CD8^＋ in the non-diabetic obese group significantly decreased,the ratio of CD4^＋/CD8^＋ significantly increased,there were significant statistical difference（P 〈 0. 05 or P 〈 0. 01 ） in the two groups comparison. Compared with the non-diabetic obese group,the subpepulations cell population of CD3^＋ 及 CD8^＋ in diabetic obese group significantly increased,the ratio of CD4^＋/CD8^＋ significantly increased （P 〈 0. 05 ）. Conclusion T2DM patients should prevent the hyperinsulinemia, control blood sugar, reduce insulin resistance, sustain normal lipid metabolism, boost immune function.