血清TNF-α与2型糖尿病合并代谢综合征的相关性研究

首都医科大学学报 ›› 2007, Vol. 28 ›› Issue (3): 296-299.

血清TNF-α与2型糖尿病合并代谢综合征的相关性研究

伦媛媛¹, 王立¹, 杨金奎²

1. 首都医科大学宣武医院内分泌科;2. 首都医科大学附属北京同仁医院内分泌科

收稿日期:2007-04-10 修回日期:1900-01-01 出版日期:2007-06-24 发布日期:2007-06-24
通讯作者: 王立

Studies on the Inter-relationship between the Level of Serum TNF-α and Type 2 Diabetes Mellitus Complicating Metabolic Syndrome

Lun Yuanyuan¹, Wang Li¹, Yang Jinkui²

1. Department of Endocrinology, Xuanwu Hospital, Capital Medical University;2. Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University

Received:2007-04-10 Revised:1900-01-01 Online:2007-06-24 Published:2007-06-24

摘要/Abstract

摘要：

目的探讨血清肿瘤坏死因子α(TNF-α)水平与2型糖尿病及代谢综合症的相关情况及其可能的作用机制。方法首都医科大学宣武医院2004年5月至2006年11月住院的257例2型糖尿病患者,病史在6个月以上,排除急慢性感染及其他内分泌疾病,肝功能正常。将病例组根据有无合并代谢综合征分为2型糖尿病合并代谢综合征组(MS组,174例)和2型糖尿病不合并代谢综合征组(NMS组,83例),另设健康对照组43例。检测3组血清TNF-α水平,测定C反应蛋白(CRP)、白介素-1(IL-1)、白介素-2(IL-2)、白介素-6(IL-6)、白介素-8(IL-8)、纤维蛋白溶解酶原激活因子抑制物-1(PAI-1)和血脂并进行分析,比较病例2组间大血管病和脂肪肝患病率的差异。通过放射免疫法测定TNF-α。采用SPSS 11.5进行统计分析。结果 ①MS组的血清TNF-α水平明显高于NMS组(P<0.01),且2组TNF-α水平均高于对照组(P<0.01或P<0.05)。②MS组和NMS组大血管患病率分别为60.9%和45.8%,2者间差异有统计学意义(P<0.05)。MS组和NMS组脂肪肝患病率分别为39.1%和15.7%,2者间差异有统计学意义(P<0.01)。③将糖尿病组作为整体,简单直线相关分析显示,血清TNF-α水平与三酰甘油(TG)、总胆固醇(TC)、游离脂肪酸(FFA)、C肽、IL-1、IL-2、IL-6、IL-8呈正相关。多元逐步回归分析显示,腰臀比(WHR)、TG、低密度脂蛋白胆固醇(LDL-C)、IL-1、IL-2、IL-6作为独立危险因素影响血清TNF-α水平(标准化系数分别为0.652、0.112、0.139、0.077、0.064和0.158,P值分别为0.000、0.001、0.035、0.008、0.035和0.000)。结论 TNF-α参与2型糖尿病的发生,代谢紊乱状态和炎症对合并症的发生有重要作用。

关键词: 2型糖尿病, 代谢综合征, 肿瘤坏死因子&alpha

Abstract:

Objective To investigate the role of serum tumor necrosis factor-α(TNF-α) in the pathogenesis of type 2 diabetes mellitus complicating metabolic syndrome.Methods Two hundred and fifty seven patients were diagnosed as T2DM,they were found to have acute or chronic infections,as well as other endocrine diseases,their liver function was normal.According to the 2005 IDF MS definition,the patients were divided into MS(T2DM with MS,n=174) and NMS(T2DM without MS,n=83),control group included 43 healthy subjects.The serum levels of TNF-α with RIA.Differences in blood lipid,HbA1c CRP,PAI-1,IL-1,IL-2,IL-6,IL-8 and so on among groups were observed.Data were analyzed with SPSS 11.5.Results ① The TNF-α levels in T2DM patients with MS were significantly higher compared with patients without MS,and the TNF-α levels in patients with T2DM were higher than those in the control group(P<0.01,P<0.05) respectively.② The incidence of macro-vascular complications in group MS was 60.9%,and in group NMS 45.8%,the difference was significant statistically(P<0.05).The incidence of fatty liver in group MS was 39.1%,and in group NMS 15.7%(P<0.01).③ By variable correlations showed a positive correlations between the serum TNF-α level and TG,TCH,FFA,FCP,IL-1,IL-2,IL-6 and IL-8.Multiple regression showed WHR,TG,LDL-C,IL-1,IL-2 and IL-6 were equal predictors of serum TNF-α level.Conclusion The level of serum TNF-α in patients with T2DM is higher compared with the control group.The level of serum TNF-α in the T2DM patients with MS is higher than the T2DM patients without MS.This indicates serum TNF-α plays an important role in T2DM,and it may facilitate the development of MS.Multiple regression showed WHR,TG,LDL-C,IL-1,IL-2,IL-6 and IL8 are equal predictors of serum TNF-α level.In the group T2DM with MS,the morbidity of macro-vascular complication and fatty liver is significantly increased compared with that in the group T2DM without MS,this indicates that disorders of metabolism and inflammationplay an important role in the development of complications of T2DM.The aim of treating T2DM therefore not only lowering blood glucose,but also controlling the level of blood lipid and inflammation.

Key words: type 2 diabetes mellitus, metabolic syndrome, tumor necrosis factor-&alpha

中图分类号:

R587.1

伦媛媛;王立;杨金奎. 血清TNF-α与2型糖尿病合并代谢综合征的相关性研究[J]. 首都医科大学学报, 2007, 28(3): 296-299.

Lun Yuanyuan;Wang Li;Yang Jinkui. Studies on the Inter-relationship between the Level of Serum TNF-α and Type 2 Diabetes Mellitus Complicating Metabolic Syndrome[J]. Journal of Capital Medical University, 2007, 28(3): 296-299.

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