晚期恶性肿瘤患者血清TNF-α和IL-6水平与胰岛β细胞功能不全的关系分析  

Analysis of serum TNF-αand IL-6 levels in patients with advanced malignant tumors and their relationships with isletβ-cell dysfunction

作　　者：吴文清[1] 万玲 徐秀芬 周媛[2] 邓兰[1] 朱骏 王占科 WU Wenqing;WAN Ling;XU Xiufen;ZHOU Yuan;DENG Lan;ZHU Jun;WANG Zhanke(Department of Oncology, No.98 Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, Yingtan 335000, China)

机构地区：[1]中国人民解放军联勤保障部队第九○八医院肿瘤科,江西鹰潭335000 [2]中国人民解放军联勤保障部队第九○八医院检验科,330002 [3]宁波鄞州中医院内分泌科,315040 [4]宁波美康盛德医学检验所,315040

出　　处：《临床肿瘤学杂志》2021年第12期1127-1130,共4页Chinese Clinical Oncology

基　　金：江西省卫生健康委课题资助项目(20190315)。

摘　　要：目的探讨晚期恶性肿瘤患者血清肿瘤坏死因子α(TNF-α)和白细胞介素6(IL-6)水平与胰岛β细胞功能不全的关系。方法选择本院2019年6月1日至2020年12月31日符合入选标准及不符合排除标准的晚期恶性肿瘤患者40例为研究组,以同期的40例健康体检正常人群为对照组,测定两组的糖代谢障碍指标[空腹血糖(GLU_(0))、空腹乳酸(LA_(0))和糖负荷后乳酸增量和血糖增量比值(ΔLA_(30)/ΔGLU_(30))]、胰岛β细胞功能指标[稳态模式评估法的胰岛素分泌指数(HOMA-β)和糖负荷后胰岛素增量和血糖增量比值(ΔINS_(30)/ΔGLU_(30))]以及炎症因子指标[TNF-α和IL-6]水平,分析炎症因子指标和胰岛β细胞功能指标水平的相关性。结果研究组的GLU_(0)和LA_(0)分别为(5.945±0.735)和(3.443±0.621)mmol/L,高于对照组的(4.240±0.906)和(1.302±0.502)mmol/L,研究组的ΔLA_(30)/ΔGLU_(30)为2.149±0.340,高于对照组的0.924±0.145,差异均有统计学意义(P<0.05)。研究组的HOMA-β指数和ΔINS30/ΔGLU_(30)分别为98.320±12.324和5.108±1.123,低于对照组的251.014±58.875和11.247±2.644,差异均有统计学意义(P<0.05)。研究组的TNF-α和IL-6水平分别为(4.245±0.841)和(7.938±1.043)μg/L,高于对照组的(1.560±0.206)和(2.554±0.539)μg/L,差异均有统计学意义(P<0.05)。研究组血清TNF-α水平与HOMA-β指数和ΔINS_(30)/ΔGLU_(30)的相关系数分别为0.4329和0.5802,血清IL-6水平与HOMA-β指数和ΔINS_(30)/ΔGLU_(30)的相关系数分别为0.5024和0.6093,差异均有统计学意义(P<0.05)。结论晚期恶性肿瘤患者存在胰岛β细胞基础和快速分泌胰岛素功能不全和糖代谢障碍,血清TNF-α和IL-6升高可能在恶性肿瘤患者胰岛β细胞功能不全和糖代谢障碍发生发展中发挥重要作用。Objective To explore the serum levels of tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)in patients with advanced malignant tumors and their relationships with isletβ-cell dysfunction.Methods From June 1,2019 to December 31,2020,40 patients with advanced malignant tumors who met the inclusion criteria and did not meet the exclusion criteria were selected as the research group,and 40 healthy people in the same period were selected as the control group.Indices of both groups were measured as follows:glucose metabolism disorder including fasting blood glucose(GLU_(0)),fasting lactic acid(LA_(0))and ratio of lactate increment to blood glucose increment after glucose load(ΔLA_(30)/ΔGLU_(30)),isletβ-cell function including homeostasis model assessment insulin secretion index(HOMA-β)and ratio of insulin increment to blood glucose increment after glucose load(ΔINS_(30)/ΔGLU_(30))and inflammatory factor including TNF-αand IL-6.Correlation between inflammatory factors and isletβ-cell function indices were analyzed.Results For research group,GLU_(0) and LA_(0) were(5.945±0.735)and(3.443±0.621)mmol/L respectively,higher than(4.240±0.906)and(1.302±0.502)mmol/L in the control group,andΔLA_(30)/ΔGLU_(30) was 2.149±0.340,higher than 0.924±0.145 in the control group(P<0.05).HOMA-βandΔINS_(30)/ΔGLU_(30) were 98.320±12.324 and 5.108±1.123 in research group respectively,lower than 251.014±58.875 and 11.247±2.644 in control group(P<0.05).Serum TNF-αand IL-6 levels in research group were(4.245±0.841)and(7.938±1.043)μg/L respectively,higher than(1.560±0.206)and(2.554±0.539)μg/L in control group(P<0.05).For research group,the correlation coefficients of serum TNF-αlevel with HOMA-βandΔINS_(30)/ΔGLU_(30) were 0.4329 and 0.5802,and correlation coefficients of serum IL-6 level with HOMA-βandΔINS_(30)/ΔGLU_(30) were 0.5024 and 0.6093.Conclusion Patients with advanced malignancies exists dysfunction of basal and rapidly secreting insulin in pancreaticβcells,and the glucose metabolism disorder in

关 键 词：晚期恶性肿瘤 糖代谢障碍 胰岛Β细胞 炎症因子 

分 类 号：R73[医药卫生—肿瘤]