2型糖尿病患者血糖控制前后炎症因子水平变化

Changes of inflammatory factor level in 2-diabetes patients before and after improving glycemic control

目的 探讨2型糖尿病患者血糖控制前、后炎症因子水平变化.方法 选择血糖控制不良的2型糖尿病患者48例,同时选择44名健康体检者为对照组.应用液体芯片法检测对照组及糖尿病患者血糖控制前后5种细胞因子浓度.结果 糖尿病组C反应蛋白(CRP) [3.96(3.45,5.58) mg/L]、单核细胞趋化因子1(MCP-1)[(195.0±129.8)ng/L]均显著高于对照组[2.25(1.24,3.22) mg/L (Z=-2.580,P=0.010)与(148.5±85.7) ng/L(t=-2.118,P=0.047)],而白细胞介素6(IL-6)、白细胞介素8(IL-8)、转化生长因子-β1(TGF-β1)浓度组间比较差异均无统计学意义(P均＞0.05).糖尿病患者血糖得到有效控制后TGF-β1水平由43.5(26.5,62.25) g/L下降到26.85(23.17,31.12) ng/L,差异有统计学意义(Z=-2.191,P=0.028),其他4种炎症因子在血糖控制前后比较差异均无统计学意义(CRP:Z=-0.937,P=0.372;IL-6:Z=-0.875,P=0.396;IL-8:Z=-1.215,P=0.286;MCP-1:t=-1.846,P=0.065).结论 2型糖尿病患者处于低级别炎症状态,血糖控制能够降低TGF-β1水平,对糖尿病肾病进展具有保护作用.

Objective To investigate the inflammation levels of 2-diabetes patients before and after 3 months of improving glycemic control.Methods A longitudinal study was performed in a subgroup of 48 subjects with T2D and poor glycemic control.Forty-four healthy individuals were taken as control group.The serum concentration of C-reactionprotein (CRP),interleukin-6 (IL-6),interleukin-6 (IL-8),transforming growth factor-β1 (TGF-β1) and transforming growth factor-β1 (MCP1) in all participants were measured simultaneously by multiplexed Luminex assay.Results The serum levels of CRP,MCP-1 of 2-diabetes patients were 3.96 (3.45,5.58) mg/L and (195.0± 129.8) ng/L,significant higher than those in control group (2.25 (1.24,3.22) mg/L,(148.5±85.7) ng/L),and the differences were significant(t=-2.580,P=0.010;t=-2.118,P =0.047).No significant difference was found in the serum levels of IL-6,IL-8,TGF-β lbetween the two groups (P＞0.05).TGF-β1 level in patients with good glycemic control decreased to 26.85 (23.17-31.12) ng/l,significant lower than that before glycemic control (43.5(26.5-62.25) g/L;Z=-2.191,P=0.028),and there were no significant differences among the other 4 kinds of inflammatory factors before and after blood glucose control(CRP:Z =-0.937P =0.372;IL-6:Z =-0.875,P =0.396;IL-8:Z =-1.215,P =0.286;MCP-1:t =-1.846,P=0.065).Conclusion Low grade systemic inflammation status in T2D patients.Improvement of glycemic control reduces TGF-β1 levels and plays a key role in delaying the development of diabetic nephropathy.