2型糖尿病血清肿瘤坏死因子α水平与胰岛素抵抗关系(英文)  

Relationship between TNF-α level and insulin resistance in type 2 diabetes

作　　者：刘军[1] 陈影[1] 姚庆姑[1] 

机构地区：[1]复旦大学附属上海市第五人民医院内分泌科,上海200240

出　　处：《中国现代医学杂志》2003年第22期22-25,共4页China Journal of Modern Medicine

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 10 1例 ,糖耐量异常组 2 7例和正常对照组 18例血清TNF -α水平 ,用稳态模式 (HomaModel)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 .0 5 ) ,高密度脂蛋白胆固醇水平 (HDL -C)低于正常对照组 (P <0 .0 5 )。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 .4 5 1、0 .2 4 5、0 .2 18、0 .16 2 ,P值分别为 0 .0 0 0、0 .0 0 10 .0 0 3、0 .0 30 )。TNF -α水平与舒张压 (DBP)、空腹血糖 (FBG)、餐后 2h血糖 (BG 2h)、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 .2 18、0 .374、0 .317、0 .2 93、0 .2 18、0 .2 15、0 .4 2 2、0 .2 0 0 ) ,与BMI、WHR不相关。结论　 2型糖尿病患者TNF-α水平明显升高 。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.

关 键 词：糖尿病 非胰岛素依赖型 胰岛素抵抗 肿瘤坏死因子-Α 

分 类 号：R587.1[医药卫生—内分泌]