不同切点空腹血糖受损中老年患者血浆干扰素γ和白介素4变化及其临床意义

Changes and the clinical significance of IFN-gamma and interleukin-4 in middle-aged and elderly patients with different levels of impaired fasting glucose

目的探讨辅助性T细胞1型/2型(Th1/Th2)免疫失衡在中老年IFG发病中的作用及与IR的关系。方法根据FPG及2hPG将381例中老年糖尿病患者分为IFG1、IFG2、IGT、T2DM、糖耐量正常(NGT)组。ELISA检测血浆干扰素γ(IFN-γ)、白介素-4(IL-4),同时检测胰岛素及HbA1c水平。结果 IFG1、IFG2、IGT组与NGT组比较,胰岛素抵抗指数(HOMA-IR)均增加(P<0.05),但3组间差异无统计学意义(P>0.05)。T2DM组与其他组比较,HOMA-IR差异有统计学意义(P<0.05),IFG1、IFG2、IGT、T2DM组胰岛β细胞功能指数(HOMA-β)与NGT组比较均降低(P<0.05),IFG2组与IFG1组比较,IFN-γ升高(P<0.05),IL-4变化差异无统计学意义(P>0.05)。结论中老年IFG人群存在IFN-γ和IL-4升高,HOMA-IR与HOMA-β下降。

Objective To investigate the role of T helpar call type 1 and 2（Th1/Th2）immune imbalance in elderly diabetic patients with different levels of impaired fasting glucose （IFG） and the relationship with insulin resistance（IR）.Methods A cohort of 381 diabetic patients,older than 55 years of age,was divided into five groups：the normal group,IFG1 group（5.6～6.1 mmol/L）,IFG2 group（6.1～7.0 mmol/L）,IGT group and T2DM group according to the levels of fasting plasma glucose （FPG） and 2 h postprandial plasma glucose（2 hPG）.The serum cytokines of interferon-γ（IFN-γ） and interleukin-4（IL-4） were measured by enzyme-linked immunosorbent assay（ELISA）.Insulin （Ins） and HbA1c were measured.Results The levels of HOMA-IR in IFG1,IFG2,IGT groups were significantly higher than those in normal group （P＜0.05）.But no significant difference was observed among IFG1,IFG2 and IGT groups （P＞0.05）.The levels of HOMA-IR were significantly higher in T2DM group than in the other four groups （P＜0.05）.The level of HOMA-β in the normal group was significant higher than that in the other four groups（P＜0.05）.The IGT group had minimal function damage in HOMA-β.Compared with IFG1 group,IFG2 group had higher IFN-γ level （P＜0.05）,and there was no significant difference in IL-4 between two groups（P＞0.05）.Conclusion IFN-γand IL-4 are increase but HOMA-IR and HOMA-β are decrease in middle-aged and elder patients with different levels of IFG.