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