胰岛素强化治疗对初诊2型糖尿病患者单核细胞趋化蛋白-1、核因子-κB表达的影响

Effects of intensive insulin therapy on monocyte chemotactic protein-1 and nuclear factor-κB of newly-diagnosed type 2 diabetic patients

目的探讨短期胰岛素强化治疗对2型糖尿病患者外周血单核细胞上单核细胞趋化蛋白-1(Monocyte chemotactic protein-1,MCP-1)和核因子-κB(Nuclear factor kappa B,NF-κB)表达的影响。方法选择健康成人20例,新诊断2型糖尿病患者20例,分为正常对照组和糖尿病组,糖尿病组采取胰岛素强化治疗,疗程2周。留取清晨空腹肘静脉血5mL,分离出单核细胞,采用流式细胞仪检测胰岛素强化治疗前后单核细胞上MCP-1和NF-κB的表达;同时检测治疗前后Homa-IR、WBC、N%。结果短期胰岛素强化治疗后:外周血单核细胞上MCP-1和NF-κB的表达水平显著降低(P<0.01),由治疗前的(0.89±0.26)%、(15.53±2.49)%分别下降为(0.50±0.18)%、(12.22±2.80)%;Homa-IR,WBC和N%明显降低;单核细胞MCP-1和NF-κB表达水平与Homa-IR、WBC和N%变化无明显相关性。结论2型糖尿病患者体内存在增强的低度炎症反应,胰岛素强化治疗可降低外周血单核细胞上MCP-1和NF-κB蛋白的表达,提示胰岛素除降糖作用外,尚有一定的抗炎作用。

【Objective】To investigate the effects of transient intensive insulin therapy on the monocyte chemotactic protein-1（MCP-1） on the monocyte surface and nuclear factor-κB（NF-κB） expression in the monocyte of newly-diagnosed type 2 diabetic patients.【Methods】Totally 20 healthy normal controls and 20 patients diagnosed as type 2 diabetes were recruited.All patients were treated with intensive insulin therapy for 2 weeks.Samples of 5 mL blood were taken from ulnar vein on an empty stomach in the morning.Mononuclear cells were separated from whole blood.The MCP-1 and NF-κB expressions of the monocyte cells were measured by flow cytometry before and after treatment.And the changes of Homa-IR,white blood cell（WBC）,N % were also analyzed before and after therapy.【Results】After 2 weeks of the treatment,the expression levels of MCP-1 and NF-κB of the monocytes were significantly decreased from（0.89±0.26） %,（15.53±2.49） % to（0.50±0.18） %,（12.22±2.80） % respectively（P 0.05）.HOMA-IR,WBC and N % decreased significantly compared with those before treatment.The expression levels of MCP-1 and NF-κB had no obvious correlation with the change of Homa-IR,WBC and N %.【Conclusion】Type 2 diabetes is a kind of fortified inflammatory reactive state,intensive insulin therapy can decrease the expression of MCP-1 and NF-κB in the peripheral blood mononuclear cells,so insulin has the effect of alleviating inflammatory reaction except for lowering blood glucose in type 2 diabetics.