【摘要】 目的探讨2型糖尿病患者血清单核细胞趋化蛋白1(monocyte chemotactic protein-1,MCP-1)、白细胞介素18(IL-18)水平与颈动脉内膜中膜厚度(carotid inti ma-media thickness,CI MT)的关系。方法60例2型糖尿病患者分为大血管病变组30例和无大血管病变组30例,体检健康者为对照组30例。超声测定CI MT,酶联免疫吸附法测定血清MCP-1、IL-18水平。结果2型糖尿病有、无大血管病变组血清MCP-1(无大血管病变组血清MCP-1除外)、IL-18、CI MT明显高于对照组,MCP-1(387.57±75.41)ng/L,(177.48±38.35)ng/L vs(122.51±8.98)ng/L,IL-18(54.76±16.31)ng/L、(35.08±8.83)ng/L vs(26.13±7.05)ng/L,CI MT(1.44±0.33)mm、(1.06±0.26)mmvs(0.68±0.12)mm(均P<0.01);大血管病变组上述指标又高于无大血管病变组(均P<0.01)。直线相关分析显示2型糖尿病患者血清MCP-1与空腹血糖(FPG)、餐后2小时血糖(2 hPG)、糖化血红蛋白、收缩压、低密度脂蛋白胆固醇、CI MT和IL-18呈正相关(P<0.01或<0.05);血清IL-18与FPG、2 hPG、甘油三酯、CI MT、MCP-1呈正相关(P<0.01或<0.05)。多元线性回归分析显示年龄、MCP-1、IL-18是CI MT升高的危险因素(t=2.694、6.466、2.445,均P<0.01)。结论2型糖尿病患者血清MCP-1、IL-18与CI MT密切相关,提示两者可能是亚临床期动脉粥样硬化的危险因素。更多还原

【Abstract】 Objective To investigate the association of serum monocyte chemotactic protein-1(MCP-1),interlenkin-18(IL-18) and the carotid intima-media thickness(CIMT) in patients with type 2 diabetes.Methods 90 serum specimens were collected from 60 patients with type 2 diabetes and 30 matched healthy subjects.The patients of type 2 diabetes were divided into two groups: macrovascular complication group(MVC,n=30) and non-macrovascular complication group(non-MVC,n=30).The levels of serum MCP-1 and IL-18 were detected by enzyme-linked immunosorbent assay.The IMT was examined by hypersensitive color Doppler ultrasonography.Results The level of serum MCP-1 was significantly higher in type 2 diabetes patients with MVC group,non-MVC group than in age-matched controll group,MCP-1 level(387.57±75.41) ng/L,(177.48±38.35) ng/L vs(122.51±8.98) ng/L.The serum IL-18 and CIMT were significantly higher in the former two groups than those in age-matched controlled group,IL-18(54.76±16.31) ng/L,(35.08±8.83) ng/L vs(26.13±7.05) ng/L,CIMT(1.44±0.33) mm,(1.06±0.26) mm vs(0.68±0.12) mm(all P<0.01).The above indexes in MVC group were higher than those in non-MVC group.Spearman correlation analysis showed that MCP-1 was positive correlated with fasting plasma glucose(FPG),2-hour postprandial plasma glucose(2 hPG),glycohemoglobin,systolic blood pressure,low density lipoprotein cholesterol,CIMT and IL-18 in type 2 diabetes patients group and IL-18 positive correlated with FPG,2 hPG,triglyceride,CIMT,MCP-1.Linear regression analysis showed that the serum MCP-1 and IL-18 levels were risk factors for elevated CIMT.Conclusion The study suggests that there is a strong correlation between MCP-1,IL-18 and CIMT.MCP-1,IL-18 might be important independent risk factors for subclinical macrovascular complications.更多还原