摘要
目的检测1型糖尿病合并自身免疫性甲状腺疾病(AITD)胰岛相关抗体及甲状腺相关抗体阳性率及其外周血Th1、Th2、Th17、Treg相关细胞因子表达水平,分析1型糖尿病合并AITD临床特点,探讨各细胞因子在1型糖尿病发生发展中的作用。方法收集1型糖尿病患者63例,对照组为来我院健康体检者57例,采集静脉血,检测胰岛相关抗体、甲状腺相关抗体及IFN-γ、IL-4、IL-10、IL-17细胞因子表达水平。结果 1型糖尿病组IFN-γ及IL-17表达水明显高于正常对照组[(400.95±51.44)pg/ml vs.(340.99±39.47)pg/ml,P<0.01;(26.87±±2.47)pg/ml vs.(19.41±2.80)pg/ml,P<0.01],IL-4及IL-10表达水平均低于正常组[(21.63±4.22)pg/ml vs.(31.49±2.42)pg/ml,P<0.01;(15.69±3.22)pg/ml vs.(24.13±2.17)pg/ml,P<0.01],差异均有统计学意义。1型糖尿病任一胰岛相关抗体阳性组,TPO-Ab、TG-Ab、TR-Ab阳性率均高于胰岛相关抗体阴性组,差异有统计学意义(P<0.05),但各细胞因子表达无明显差异。1型糖尿病患者血清IL-17水平与HbA1c水平正相关(r=0.59,P<0.05)。结论 1型糖尿病患者CD4+T细胞各亚群间平衡失调,Th1/Th2及Th17/Treg平衡失调,向Th1及Th17方向漂移,细胞免疫及IL-17介导的前炎症反应在1型糖尿病起病中发挥主要作用,1型糖尿病胰岛相关抗体阳性患者,具有更高的甲状腺相关抗体阳性率,可能具有更高的自身免疫性甲状腺疾病风险。
Objective To detect the plasma concentrations of some cytokines expressed by relevant Th1, Th2, Th17, Treg and to observe the ratio of positive about glutamic acid decarboxylase antibodies(GAD-Ab), insulin autoantibodies(IAA) and islet cell antibodies(ICA) who were diagnosed with type 1 diabetes(T1DM) and autoimmune thyroid disease(AITD). Analysis the clinical characteristics and to explore the use of these cytokines in the development of these patients. Methods 63 patients diagnosed with type 1 diabetes mellitus and autoimmune thyroid disease were collected, control group of 57 cases. Collected the peripheral blood, to detect islet-related antibodies, thyroid-associated antibodies. Sandwich enzyme-linked immunosorbent assay for detection of IFN-γ, IL-4, IL-10, IL-17. Results In type 1 diabetes group, IFN-γand IL-17 expression levels were higher than the normal control group. IL-4 and IL-10 were lower than the normal control group. In the group any one islet-related antibodies positive, TPO-Ab, TG-Ab, TR-Ab positive rates were higher, the difference was statistically significant (P〈0.05), but the level of cytokines were not statistically significant. T1DM group serum IL-17 levels and HbA1c were positively correlated (r=0.59, P〈0.05). Conclusion Type 1 diabetes CD4+T cell subsets imbalance, Th1/Th2 and Th17/Treg are imbalance, cellular immunity and IL-17 mediated inflammatory play major role in T1DM. In type 1 diabetes patients any one islet-related antibodies positive, have higher rates of thyroid-associated antibodies, may have a higher risk of autoimmune thyroid disease.
出处
《中华临床医师杂志(电子版)》
CAS
2013年第24期84-87,共4页
Chinese Journal of Clinicians(Electronic Edition)
基金
国家自然科学基金(81370922)