血清Tim-3、IL-17及IFN-γ在儿童糖尿病中的临床意义

目的探讨儿童糖尿病血清T细胞免疫球蛋白黏蛋白分子3(Tim-3)、白细胞介素17(IL-17)及干扰素γ(IFN-γ)的表达及临床意义.方法选择2016年2月至2020年2月儿童糖尿病患儿83例(观察组),另选择同期体检健康者60例作为对照组,分析血清Tim-3、IL-17、IFN-γ、空腹血糖(FPG)、糖化血红蛋白(HbAlc)的变化情况及其相关性,采用受试者工作特征曲线分析血清Tim-3、IL-17及IFN-γ的预测价值.结果观察组患儿血清Tim-3、IL-17及IFN-γ水平高于对照组,差异有统计学意义(P<0.05);观察组患儿血清FPG、HbAlc水平高于对照组,差异有统计学意义(P<0.05);相关性分析结果中显示,血清Tim-3、IL-17及IFN-γ水平与FPG、HbAlc呈正相关(P<0.05);ROC曲线结果显示,血清Tim-3预测儿童糖尿病的曲线下面积(AUC)为0.983,95%CI:0.966~1.000,敏感度80.25%,特异度83.08%,截断值为1.43;IL-17预测儿童糖尿病的AUC为0.932,95%CI:0.893~0.972,敏感度75.00%,特异度79.53%,截断值为225.46 ng/L;IFN-γ预测儿童糖尿病的AUC为0.876,95%CI:0.821~0.932,敏感度82.50%,特异度83.14%,截断值为129.59 pg/mL;联合检测预测儿童糖尿病的AUC为0.999,95%CI:0.965~1.000,敏感度88.59%,特异度93.45%.结论儿童糖尿病患儿中血清Tim-3、IL-17及IFN-γ的表达与FPG、HbAlc之间存在密切关系,对儿童糖尿病具有较高的预测价值.

Objective To explore the expression and clinical significance of serum T cell immunoglobulin mucin molecule 3(TIM-3),interleukin-17(IL-17)and interferon(IFN-γ)in children with diabetes.Methods 83 cases of children with diabetes admitted to our hospital from February 2016 to February 2020 were selected as the subjects of this study and set as the case group,and 60 healthy subjects who underwent physical examination during the same period were selected as the control group.The changes of serum TIM-3,IL-17,IFN-γ,fasting blood glucose(FPG),HbAlc and their correlation were analyzed.The predictive value of serum TIM-3,IL-17 and IFN-were analyzed using the subject working characteristic curve.Results The serum levels of TIM-3,IL-17 and IFN-γin the case group were significantly higher than those in the control group,with statistical significance(P<0.05).The serum LEVELS of FPG and HbAlc in the case group were significantly higher than those in the control group,with statistical significance(P<0.05).Correlation analysis showed that serum TIM-3,IL-17 and IFN-γlevels were positively correlated with FPG and HbAlc(P<0.05).ROC curve results showed that the area under the curve,95%CI,sensitivity,specificity and truncation of serum TIM-3 were 0.983,0.966~1.000,80.25%,83.08%and 1.43,respectively.The area under the curve,95%CI,sensitivity,specificity and truncation of IL-17 were 0.932,0.893~0.972,75.00%,79.53%and 225.46 ng/L,respectively.The area under the curve,95%CI,sensitivity and specificity of IFN-γwere 0.876,0.821~0.932,82.50%,83.14%and 129.59 pg/mL,respectively.The area under the curve,95%CI,sensitivity and specificity of combined detection for predicting diabetes in children were 0.999,0.965~1.000,88.59%and 93.45%,respectively.Conclusion In children with diabetes,the expression of serum TIM-3,IL-17 and IFN-γis closely related to FPG and HbAlc,which has a high predictive value for children with diabetes.