摘要
目的 探讨哮喘病人血清炎症因子TNF-α、IL-6和C-反应蛋白(CRP)对胰岛β细胞功能的影响.方法 选择慢性持续期哮喘病人112例,根据哮喘病情严重程度分为轻度持续组(55例)和中度持续组(57例)两组,健康志愿者60例为对照组.分别测定血清TNF-α、IL-6及CRP水平,同时做葡萄糖耐量及胰岛素释放试验,计算胰岛素曲线下面积(AUC1)和葡萄糖曲线下面积(AUCG)的比值(AUC1/AUCG)、HOMA胰岛素抵抗指数(HOMA-IR)、胰岛素敏感指数(IS1)、HOMA-β细胞功能指数(HBCI)、早期胰岛素分泌功能指数(△130/△G30).做肺功能检查,测定第1秒用力呼气容积(FEV1)和用力肺活量(FVC).结果 与对照组比较,轻、中度持续组哮喘病人血浆TNF-α、IL-6、CRP水平明显升高,AUC1、AUC1/AUCG、HOMA-1R、HBCI明显升高,ISI下降(t=2.02~13.62,P<0.05).多因素逐步回归分析显示HOMA-IR与CRP、LDL-C、BMI、AUC1、TNF-α呈正相关(P<0.01或P<0.05),与FEV1占预计值(%)呈负相关(P<0.05).结论 哮喘病人存在胰岛素抵抗和高胰岛素血症,TNF-α、IL-6和CRP参与了胰岛素抵抗.
Objective To explore the association between inflammatory cytokines and islet β-cell function in chronic persistent asthma patients. Methods 112 adults with persistent asthma and 60 healthy volunteers were enrolled in this study. According to the severity of disease, all subjects were divided into persistent-mild group and persistent-moderate group. Plasma tumor necrosis factor-α(TNF-α), interleukin6(IL-6) and C-reactive protein (CRP) were determined. Oral glucose tolerance and insulin releasing test were performed. The ratio of the area under the curve of insulin to area under the curve of glucose ( AUC1/AUCG ), homeostasis model assessment for insulin resistance ( HOMA-IR), insulin sensitivity index( ISI),homeostasis model assessment for β-cell function (HBCI) and early insulin secretion index(△I30/△G30)were calculated. The values of forced expiratory volume in l second ( FEV1 ), forced vital capacity(FVC)and FEV1/FVC were recorded. Results In patient groups, the values for plasma TNF-α, IL-6, CRP,AUC1, AUC1/AUCG, HOMA-IR, HBCI significantly increased compared with those in control group, while ISI declined ( t =2. 02~13.62, P <0. 05). Multiple step regression analysis showed that HOMA-IR was positively correlated with CRP, LDL-C, BMI, AUC1, TNF-α( P <0. 01 orP <0. 05), but negatively correlated with FEV1 ( P < 0. 05 ). Conclusion The results indicated that inflammatory cytokines ( TNF-α,IL-6,CRP) might result in insulin resistance in asthma patients who had hyperinsulinism at the same time.
出处
《中国医师杂志》
CAS
2010年第12期1599-1602,共4页
Journal of Chinese Physician
基金
青岛市卫生局资助项目(2008-004)
青岛市市南区科技发展计划项目(2009-4-31-GG)