2型糖尿病血清肿瘤坏死因子α水平与胰岛素抵抗关系

摘要

目的探讨2型糖尿病患者肿瘤坏死因子α(TNF-α)水平与胰岛素抵抗之间的关系.方法测定了2型糖尿病组101例,糖耐量异常组27例和正常对照组18例血清TNF-α水平,用稳态模式(Homa Model)公式评估胰岛素抵抗.结果 2型糖尿病组和糖耐量异常组的胆固醇(TC)、甘油三酯(TG)、空腹和餐后2h胰岛素、体内脂肪含量(BF)、TNF-α和Homa.IR水平高于正常对照组(P＜0.05),高密度脂蛋白胆固醇水平(HDL-C)低于正常对照组(P＜0.05).多元逐步回归分析显示:空腹血糖(FBG)、体重指数(BMI)、TNF-α、TG是影响2型糖尿病病人胰岛素抵抗的主要危险因素(Beta分别为0.451、0.245、0.218、 0.162,P值分别为0.000、0.001 0.003、0.030).TNF-α水平与舒张压(DBP)、空腹血糖(FBG)、餐后2h血糖(BG2h)、空腹胰岛索(FINS)、低密度脂蛋白胆固醇(LDL-C)、TC、Homa.IR、BF显著正相关(r分别为 0.218、0.374、0.317、0.293、0.218、0.215、0.422、0.200),与BMI、WHR不相关.结论 2型糖尿病患者TNF-α水平明显升高,并可能加剧了糖尿病患者胰岛素抵抗.%Objective:To investigate the relationship between serum tumour necrosis factor alpha(TNF-α) and insulin resistance in type 2 diabetes mellitus.Methods:The level of TNF-α was measured in 101 type 2 diabetes mellitus (T2DM) patients, 27 subjects with impaired glucose tolerance(IGT) and 18 control subjects(C). Homeostasis model assessment(HOMA) was applied to assess the status of insulin resistance.Results:The results showed the levels of TC, TG, insulin of fasting and after glucose load, TNF-α, HOMA-IR and body fat percentage(BF%) were significantly increased and their HDL-C was remarkably decreased in the subjects of T2DM and IGT compared with control subjects. Stepwise multivariate linear regression analysis showed that FBG, BMI, TNF-α and TG were the main risk factors leading to insulin resistance in type 2 diabetes mellitus (β=0.451, 0.245, 0.218, 0.162, respectively; P＝0.000, 0.001, 0.003, 0.030, respectively).In all the subjects, TNF-α level was correlated to DBP, FBG, BG2h, FINS, LDL-C, TC, HOMA-IR and BF(r= 0.218, 0.374, 0.317, 0.293,0.218, 0.215,0.422, 0.200, respectively) and was not associated with BMI and WHR.Conclusions:The level of TNF-α is increased in Type 2 diabetes(T2DM), which probably aggravates insulin resistance.