白细胞介素-18、白细胞介素-6、血浆网膜素-1与2型糖尿病合并下肢血管病变的相关性

Correlation between interleukin-18,interleukin-6,plasma omentin-1 and type 2 diabetes mellitus complicated with lower extremity vascular dis ease

目的探讨白细胞介素-18(IL-18)、白细胞介素-6(IL-6)、血浆网膜素-1水平与2型糖尿病(T2DM)合并下肢血管病变(LEVD)的相关性。方法收集2019年1月至2020年1月马鞍山十七冶医院收治的100例T2DM患者的临床资料,根据是否合并LEVD分为LEVD组(n=44)和非LEVD组(n=56),另取同期本院进行健康体检的30例健康者为对照组。对T2DM合并LEVD进行单因素、多因素Logistic回归模型分析,并分析IL-18、IL-6、血浆网膜素-1与T2DM合并LEVD的相关性。结果3组患者性别、年龄、体重指数、T2DM病程、吸烟史比较,差异均无统计学意义(P>0.05)。3组患者空腹血糖(FPG)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、丙氨酸转氨酶(ALT)、血清肌酐(SCr)、糖化血红蛋白(HbA1c)、IL-18、IL-6、血浆网膜素-1水平比较,差异均有统计学意义(P<0.05)。LEVD组和非LEVD组患者FPG、TG、TC、LDL-C、ALT、SCr、HbA1c、IL-18、IL-6水平均明显高于对照组患者(P<0.01),HDL-C、血浆网膜素-1水平均明显低于对照组患者(P<0.01);LEVD组患者FPG、TG、TC、LDL-C、ALT、SCr、HbA1c、IL-18、IL-6水平均明显高于非LEVD组患者(P<0.01),HDL-C、血浆网膜素-1水平均明显低于非LEVD组患者(P<0.01)。不同LEVD分级组患者IL-18、IL-6、血浆网膜素-1水平比较,差异均有统计学意义(P<0.05);轻度组和中度组患者IL-18、IL-6水平均明显低于重度组患者(P<0.01),血浆网膜素-1水平均明显高于重度组患者(P<0.01);轻度组患者IL-18、IL-6水平均明显较低于中度组患者(P<0.01),血浆网膜素-1水平明显高于中度组患者(P<0.01)。多因素分析结果显示,FPG、TG、TC、IL-18、IL-6、血浆网膜素-1均是T2DM患者发生LEVD的影响因素(P<0.05)。Pearson相关性分析显示,T2DM合并LEVD患者IL-18与ALT、SCr、HbA1c均呈正相关(P<0.05);IL-6与TG、TC、LDL-C、ALT、SCr、HbA1c均呈正相关(P<0.05),与HDL-C、FPG均呈负相关(P<0.05);血浆网膜素-1与TG、HbA1c均呈负相关(P<0.05)。结论T2DM合并LEVD患者IL-18、IL-6水平均明显较高,血浆网膜素-1水平明显较低,IL-18、IL-6、血浆网膜素-1水平有望成为T2DM合并LEVD的预测指标,可为预防T2DM患者发生LEVD提供新靶点。

Objective To analyze the correlation between interleukin-18(IL-18),interleukin-6(IL-6),plasma omentin-1 and type 2 diabetes mellitus(T2DM)complicated with lower extremity vascular disease(LEVD).Method A total of 100 T2DM patients admitted to Maanshan 17th Metallurgical Hospital from January 2019 to January 2020 were divided into LEVD group(n=44)and non-LEVD group(n=56)according to whether LEVD was combined or not,and 30 healthy patients who underwent physical examination in our hospital during the same period were selected as the control group.Another 30 cases who underwent physical examination in our hospital during the same period were selected as the control group.Single factor and multi factor logistic regression models were used to analyze T2DM patients with LEVD,and the correlation between IL-18,IL-6,plasma omentin-1 and T2DM patients with LEVD were analyzed.Result There were no significant differences in gender,age,body mass index,T2DM course and smoking history among the three groups(P>0.05).The levels of fasting blood glucose(FPG),triglyceride(TG),total cholesterol(TC),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),alanine aminotransferase(ALT),serum creatinine(SCr),glycosylated hemoglobin(HbA1c),IL-18,IL-6 and plasma omentin-1 in the three groups were statistically significant(P<0.05).The levels of FPG,TG,TC,LDL-C,ALT,SCr,HbA1c,IL-18 and IL-6 in patients with LEVD group and non-LEVD group were significantly higher than those in patients with control group(P<0.01),while the levels of HDL-C and plasma omentin-1 were significantly lower than those in patients with control group(P<0.01).The levels of FPG,TG,TC,LDL-C,ALT,SCr,HbA1c,IL-18 and IL-6 in patients with LEVD group were significantly higher than those in patients without LEVD group,and the levels of HDL-C and plasma omentin-1 were significantly lower than those in patients with non-LEVD group(P<0.01).The levels of IL-18,IL-6 and plasma omentin-1 in patients with different LEVD grades were significantly different(P<0.05);the levels of IL-18 and IL-6 in mild group and moderate group were significantly lower than those in severe group(P<0.01);and the levels of plasma omentin-1 were significantly higher than those in severe group(P<0.01);the levels of IL-18 and IL-6 in mild group was significantly lower than that in moderate group(P<0.01),and the level of plasma omentin-1 was significantly higher than that in moderate group(P<0.01).Multivariate analysis showed that FPG,TG,TC,IL-18,IL-6,and plasma omentin-1 were the influencing factors of LEVD in T2DM patients(P<0.05).Pearson correlation analysis showed that IL-18 were positively correlated with ALT,SCr and HbA1c in T2DM patients with LEVD(P<0.05);IL-6 were positively correlated with TG,TC,LDL-C,ALT,SCr,HbA1c(P<0.05),and negatively correlated with HDL-C and FPG(P<0.05);there were negative correlation between plasma omentin-1 and TG,HbA1c(P<0.05).Conclusion The average levels of IL-18 and IL-6 in T2DM patients with LEVD are significantly higher,and the level of plasma omentin-1 is significantly lower.The levels of IL-18,IL-6 and plasma omentin-1 are expected to be predictive indicators of T2DM patients with LEVD,which could provide a new target for the prevention of T2DM patients with LEVD.