血清白介素-23、白介素-17与成人隐匿性自身免疫糖尿病患者β细胞功能的相关性

Analysis of the correlation between IL-23,IL-17andβ-cell function in latent autoimmune diabetes in adult patients

目的分析成人隐匿性自身免疫糖尿病(LADA)患者血清白介素-23(IL-23)、白介素-17(IL-17)水平,并探讨其与LADA患者β细胞功能的关系。方法选取2011年至2016年山东省龙口市人民医院住院的LADA患者(LADA组)40例、健康体检者(正常对照组)40例,收集其临床资料和生化指标,用酶联免疫法测定血清IL-23、IL-17水平并比较两组之间差异。在LADA患者中,将有统计学意义白介素水平为因变量,其余指标为自变量行Pearson相关分析,有密切相关的自变量纳入多元逐步回归分析。结果LADA组血清IL-23、IL-17水平及IL-23/IL-17均明显高于正常对照组[3.54(2.88~5.24)μg/L vs 1.98(1.62~2.18)μg/L,P<0.05],[22.42(17.71~26.07)ng/L vs 17.97(17.15~20.70)ng/L,P<0.05],(175.79±38.67 vs 105.22±19.08,P<0.01)。LADA组血清IL-23、IL-17与空腹C肽(FCP)呈负相关(r=-0.42,r=-0.48,P<0.05)。IL-23/IL-17比值与空腹血糖(FPG)呈正相关(r=0.44,P=0.00)。多元逐步回归分析提示血清IL-23、IL-17与LADA患者FCP独立相关。结论IL-23和IL-17是LADA的重要促炎因子,与LADA患者FCP独立相关,可为LADA诊断提供新的免疫指标。

Objective To determine interleukin(IL)-23 and IL-17 level in latent autoimmune diabetes in adult(LADA)patients,and to explore the relationship of IL-23,IL-17andβ-cell function in these patients.Methods Forty LADA patients from 2011 to 2016 in our hospital were selected as LADA group,and forty participants were as normal control group.Clinical and biochemical data was collected and the level of the IL-23 and IL-17 was measured with the enzyme linked immunosorbent assay(ELISA).The differences in interleukin levels among the two groups were compared.Pearson correlation analysis was used for investigating the relationship between the dependent of statistical significant interleukins and the independent data in the LADA patients,all closely related variables then were included in a stepwise multiple linear regression analysis.Results The levels of serum IL-23,IL-17 and IL-23/IL-17 were significantly higher in LADA group than those in control groups[3.54(2.88~5.24)μg/L vs 1.98(1.62~2.18)μg/L,P<0.05],[22.42(17.71~26.07)ng/L vs 17.97(17.15~20.70)ng/L,P<0.05],(175.79±38.67 vs 105.22±19.08,P<0.01).IL-23 and IL-17 in the LADA group were negatively correlated with fasting C peptide(FCP)(r=-0.42,r=-0.48,P<0.05),and the ratio of IL-23/IL-17 was positively correlated with fasting plasma glucose(FPG)(r=0.44,P=0.00).Stepwise multiple liner regression analysis showed that serum IL-23 and IL-17 level were independently associated with the FCP in LADA group.Conclusions IL-23 and IL-17 were possibly important proinflammatory factor in LADA patients,and can provide the new immunodiagnosis markers for LADA.