2型糖尿病患者不同血糖控制水平葡萄糖转运蛋白1/4的表达及其对巨噬细胞迁移抑制因子的影响

Expression of GLUT1/4 in different glucose level and its effect on migration inhibitory factor in patients with type 2 diabetes mellitus

目的探讨T2DM患者不同血糖控制水平葡萄糖转运蛋白1/4(GLUT1/4)的表达及其对迁移抑制因子(MIF)的影响。方法选取T2DM患者84例(研究组)及正常健康成志愿者70名(NC组)。根据HbA1c水平将研究组再分为低水平亚组(LH)29例(HbA1c<7.0%);中水平亚组(MH)28例(7.0%≤HbA1c<10.0%);高水平亚组(HH)27例(HbA1c≥10.0%)。ELISA检测各组血浆GLUT1/4、MIF及FPG等相关指标;高效液相色谱法测定HbA1c水平;RT-PCR测定GLUT1/4、MIF表达情况。多元回归分析GLUT4与MIF、HbA1c的相关性。结果研究组FPG、2hPG、FIns与NC组比较,差异有统计学意义(P<0.05),ELISA与RT-PCR结果发现,研究组GLUT1与NC组比较,差异无统计学意义(P>0.05)。HH、MH亚组HbA1c、FIns、HOMA-IR、2hPG、TNF-α、IL-6、细胞间黏附因子-1(ICAM-1)、MIF及GLUT4均高于LH亚组(P<0.05),HH亚组HbA1c、FIns、TNF-α、IL-6、ICAM-1、高敏C-反应蛋白(hsC-RP)、MIF及GLUT4高于MH亚组(P<0.05)。随着HbA1c水平的升高,各亚组GLUT4下降(P<0.05)。Logistic回归分析发现,MIF、HbA1c是GLUT4的独立危险因素。结论HbA1c、MIF在T2DM中呈高表达,其与GLUT1无相关性,而与GLUT4呈负相关。

Objective To investigate the expression of glucose transporter protein 1,4 （GLUTI/4） in different glucose level and its effect on migration inhibitory factor in patients with type 2 diabetes mellitus. Method A total of 154 subjects were enrolled in this study and divided into two groups： Patients with type 2 diabetes group （n = 84, study group） and normal healthy adult volunteers （n= 70, control group）. The study group were further divided into three subgroups according to their HbAlc levels： low HbA1 c group with HbA1 c〈7.0 % （n= 29, LH subgroup）, middle HbA1 c group with 7.0 % HbA1 c（10.0% （n = 28, MH subgroup）, and high HbAlc group with HbAlc≥10.0% （n = 27, HH subgroup）. Plasma GLUT1/4, MIF and FPG level were measured by ELISA. HbAlc was tested by HPLC. The expression of GLUT1/4 and MIF were analyzed by RT PCR. Multiple regression analysis was used to evaluate the relationship between GLUT1/4 and MIF, HbAlc. Results FPG, 2 hPG and Fins were statistically different between study group and control group （P〈0.05）. ELISA and RT-PCR test results showed that GLUT1 was not different between study group and control group （P〉0.05）. HbA1 e,FIns, HOMA-IR, 2 hPG, TNF-α, IL-6, ICAM-1, MIF and GLUT4 were higher in HH and MH subgroup than in LH subgroup （P〈 0.05）. HbAlc, Fins, TNF-α, IL-6, ICAM-1, hsC-RP, MIF and GLUT4 were higher in HH subgroup than in MH subgroup （P〈0.05）. GLUT4 decreased when HbA1 c level increased （P〈0. 05）. Logistic regression analysis showed that MIF and HbA1 c were the independent risk factor for GLUT4. Conclusion The high level of HbA1 c and MIF in T2DM patients are not associated with GLUT1, but negatively correlated with GLUT4.