【摘要】 目的探讨2型糖尿病患者血清白介素-23(IL-23)、肿瘤坏死因子-α(TNF-α)、干扰素-γ(IFN-γ)的水平与胰岛素抵抗相关性。方法将85例观察对象分为:正常对照组(NGT组)20例、新发2型糖尿病组(DM1组)33例、既往2型糖尿病组(DM2组)32例,均监测体质量、身高、腰围、臀围、空腹血糖(FPG)、胰岛素(FINS)、胆固醇(CH)、甘油三酯(TG)、糖化血红蛋白(HbA1c),并测定IL-23、TNF-α、IFN-γ浓度,简易稳态模型评估胰岛素抵抗指数(HOMA-IR)。结果DM1、DM2组的IL-23水平较NGT组明显升高(P<0.05),而DM1组又较DM2组明显升高(P<0.01);DM1、DM2组的TNF-α水平较NGT组明显升高(P<0.05),DM1、DM2组组间比较无统计学差异;三组间IFN-γ水平比较无统计学差异(P>0.01)。血清IL-23与HOMA-IR(r=0.412,P=0.001)、TNF-α(r=0.458,P=0.000)显著相关,与IFN-γ无关(P>0.05);TNF-α、IFN-γ与HOMA-IR显著相关(r=0.410,P=0.001;r=0.739,P=0.001)。结论IL-23、TNF-α是2型糖尿病胰岛素抵抗的重要细胞因子,IL-23不能通过参与调节IFN-γ发挥作用。更多还原

【Abstract】 Objective To explore the association between serum levels of interleukin-23(IL-23),tumor necrosis factor-α(TNF-α) and interferon-γ(IFN-γ) and insulin resistance in patients with type 2 diabetes.Methods Eighty-five subjects were divided into the normal control group(NGT,20 patients),the new type 2 diabetic group(DM1,33 patients) and the old type 2 diabetic group(DM2,32 patients).Weight,height,waist circle,hip circle,fasting plasma glucose(FPG),fasting insulin,total cholesterol,triglycerides and HbA1c were determined and serum levels of IL-23,TNF-α and IFN-γ were determined.A simple homeostatic model was used to evaluate insulin resistance(HOMA-IR).Results Serum IL-23 level in groups DM1 and DM2 was increased compared with group NGT(P<0.05) and was higher in the DM1 group than in the DM2 group(P<0.01).TNF-α level in groups DM1 and DM2 was increased compared with NGT(P<0.05),but there was no significant difference between group DM1 and DM2,also there was no significant difference among the DM1,DM2 and NGT groups in IFN-γ level.IL-23 level strongly correlated with HOMA-IR(r=0.412,P=0.001)and TNF-α(r=0.458,P=0.000),but did not correlate with IFN-γ(P>0.05).TNF-α(r=0.410,P=0.001)and IFN-γ(r=0.739,P=0.001)strongly related to HOMA-IR.Conclusion Serum IL-23 and TNF-α levels were significantly increased in type 2 diabetes mellitus and were strongly correlated with HOMA-IR.IFN-γ level was not significantly different between groups DM and NGT,indicating that IL-23 and TNF-α were important mediators of insulin resistance in type 2 diabetes mellitus,producing a marked effect without adjusting IFN-γ.更多还原