短期强化胰岛素治疗对2型糖尿病患者外周血单核细胞TLR4、1L-6、IL-1β表达的影响

Influence of Short-term Intensive Insulin Therapy on Expression of TLR4, IL-6, and IL-1β in Peripheral Blood Mononuclear Cells of Patients with Type-2 Diabetes Mellitus

【目的】探讨短期强化胰岛素（CSII）治疗对2型糖尿病（T2DM）患者外周血单核细胞Toll样受体-4（TLR4）、白细胞介素-6（1L-6）、白细胞介素-lβ（IL-1β）表达的影响。【方法】收集本院86例T2DM患者作为观察组，另选取健康体检者的80例作为对照组，观察组患者采用CSII治疗2周，检测观察组治疗前后外周血中空腹血糖（FPG）、餐后2h血糖（2hPG）、胰岛素抵抗指数（HOMA-IR）、三酰甘油（TG）、总胆固醇（TC）、糖化血红蛋白（HbAle）、低密度／高密度脂蛋白（HDC-L）、低密度（LDC-L）／高密度脂蛋白（HDC-L）、TLR4、lL-6，IL-1β水平并与对照组比较。【结果】治疗后FPG、2hPG、HOMA-IR、TG、TC、HbAlc均低于治疗前，其差异有统计学意义（P〈0．05）；与对照组相比，治疗后FPG、2hPG、HOMA-IR、TG、TC、HbAlc水平无明显变化（P〉0．05）。RT-PCR结果显示，治疗后外周血单核细胞TLR4、IL-1β、lL-6mRNA表达均低于治疗前，差异有统计学意义（P〈0．05）；与对照组相比，差异无统计学意义（P〉0．05）。【结论】CSII治疗T2DM能控制患者血糖及提高对胰岛素敏感性，这可能与抑制外周血单核细胞TLR4、lL-6，IL-1β表达有关。

[Objective]To explore the influence of short-term intensive insulin therapy （CSII） on toll like receptor-4 （TLR4）, interleukin-6 （1L-6）, and interleukin-lβ （IL-1β） expressions in peripheral blood mononu- clear cells of patients with type-2 diabetes mellitus （T2DM）. [Methods]A total of 86 cases of patients with T2DM treated in our hospital were selected as the observation group, and 80 cases of healthy volunteers with normal physical examination were selected as the control group. The observation group were given CSII treat- ment for two weeks. Clinical data such as the peripheral blood glucose （FPG）, postprandial 2h blood glucose （2hPG）, insulin resistance index （HOMA-IR）, triglyceride （TG）, total cholesterol （TC）, glycosylated he- moglobin （HbAlc） were measured before and after treatment in the observation group. High Density Lipopro- tein （HDC-L）, Low Density （LDC-L）/High Density Lipoprotein （HDC-L） of the two groups before and after treatment were measured, and TLR4, 1L-6, and IL-1β levels were detected by using reverse transcription poly- merase chain reaction （RT-PCR） as welL[Results]After treatment, FPG, 2hPG, HOMA-IR, TG, TC, and HbAlc were all lower than those before the treatment, and the differences were statistically significant （ P〈0.05）. However, compared to the control group, FPG, 2hFG, HOMA-IR, TG, TC, HbAlc levels did not change significantly after treatment （ P 〉 0.05）. The results of RT-PCR showed that the expressions of TLR4, IL-1 beta and 1L-6 mRNA in peripheral blood mononuclear cells after treatment were lower than those before treatment （ P 〈0.05） ;however, compared to the control group, the difference was not significant （ P 〉0.05）. [Conclusion]Short-term intensive insulin therapy （CSII） in the treatment of patients with T2DM can control blood sugar （glucose） and increase insulin sensitivity. It may be related to the inhibition of TLR4, 1L- 6, and IL-1β expressions in peripheral blood m0nonuclear cells.