Ⅱ型糖尿病患者血、尿白介素-6变化的意义

The clinical significance of elevated plasma and urinary interleukin-6 level in type II diabets mellitus

目的 :探讨II型糖尿病 (DM)患者血、尿白介素 6 (interleukin 6 ,IL 6 )水平的变化 ,了解IL 6在糖尿病肾病中的发病学意义。方法 :用放射免疫法检测 4 5例II型糖尿病患者及 2 0例正常人血、尿IL 6水平并进行比较。结果 :(1)II型糖尿病患者血、尿IL 6水平明显高于正常人 (P <0 0 5或P <0 0 1)。 (2 )早期糖尿病肾病患者尿IL 6水平明显高于单纯糖尿病患者(P<0 0 5 )。 (3)患者血IL 6水平分别与病程和空腹胰岛素 (fastinginsulin ,FINS)水平呈正相关 (r=0 30 5和 0 32 9,P 均 <0 0 5 ) ,与胰岛素敏感指数 (insulinsensitiveindex ,ISI)呈负相关 (r =- 0 35 2 ,P <0 0 2 ) ,尿IL 6水平分别与病程和尿白蛋白排泄率 (urinealbuminexcretionrate ,UAER)呈正相关 (r =0 32 6 ,P <0 0 5 ;r =0 4 6 6 ,P <0 0 1)。结论 :患者体内高水平的血清IL 6可能是II型糖尿病胰岛素抵抗病理生理改变的一种表现 ,IL 6可能参与糖尿病肾病的发生发展 ,尿IL 6水平对糖尿病肾病的病情分析有重要临床意义。

Objective:To explore the clinical significance of interleukin 6(IL 6) in pathogenesis of diabetic nephropathy by comparing the plasma and urinary level of IL 6 in patients with type 2 diabetes mellitus(DM).Methods:The plasma and urinary level of IL 6 were measured with radioimmunoassay in 20 normal controls(NC group) and 45 cases of type 2 DM,including 23 cases without albuminuria(DSM group) and 22 cases with trace albuminuria(EDN group).Results:(1)The plasms and urinary level of IL 6 markly elevated in SDM group(P<0 05, P<0 01,respectively) and EDN group (P<0 05,P<0 01,repectively) than in NC group.(2)The urinary level of IL 6 in EDN group was significantly higher than that in SDM group(P<0 05).(3)The plasma IL 6 level positively correlated with diabetes duration and fasting level of plasma insulin(r=0 305 and 0.329,respectively,P<0 05,all),negatively correlated with insulin sensitive index(r=-0.352,P<0.02).There was significant positive correlation between urinary IL 6 level and diabetes duration and urine albumin execretion rate(r= 0.326, P<0.05 and r=0 466,P<0.01,respectively).Conclusion:High plasma level of IL 6 may be a part of pathophysiological change of insulin resistance in type 2 DM.IL 6 may play an important role in the development of diabetic nephropathy.The urinary IL 6 level can be used a reference for evaluating the severity of diabetic nephropathy in type 2 DM.