摘要
目的:研讨不同程度颈动脉粥样硬化的2型糖尿病(type 2 diabetes mellitus,T2DM)患者血清白介素-10(inter-leukin-10,IL-10)的水平的变化及其与颈动脉内膜中层厚度(carotid intima-media thickness,IMT)的相关性。方法:选择沈阳医学院奉天医院内分泌科2008年6月至2009年6月住院T2DM患者共60例,并经彩色多普勒超声检测IMT将其分为三组:IMT正常组(IMT<1.0 mm)20例、IMT增厚组(1.0 mm≤IMT≤1.2 mm)20例、颈动脉粥样硬化斑块形成组(IMT>1.2 mm)20例。同时从健康查体者中选取20名志愿者作为正常对照组。受试者均晨起空腹,记录一般资料,包括身高、体重、腰围、收缩压和舒张压,并计算体重指数。口服75 g葡萄糖行葡萄糖耐量试验(oral glucose tolerance test,OGTT),采空腹静脉血10 ml,测定空腹血糖(FBG)、胰岛素(FINS)、糖化血红蛋白(hemoglobin A1C,HbA1c)、血脂及血清IL-10浓度。数据统计采用SPSS13.0软件完成。结果:T2DM患者的颈动脉IMT均值明显高于正常对照组(P<0.01),即使IMT正常的T2DM患者的IMT值亦高于正常对照组(P<0.05)。T2DM患者的血清IL-10水平明显低于正常对照组(P<0.01),在IMT正常的T2DM患者的血清IL-10浓度明显低于正常对照组(P=0.012),并且在三组不同IMT的T2DM组,IL-10水平差异亦具有显著性(P<0.05)。相关分析显示,血清IL-10水平与IMT、BMI、WC、FBG、HbA1c、TC、TG、LDL-C及HOMA-IR呈负相关,其中与IMT的相关系数最高(r=-0.74,P<0.01)。经过Logistic回归分析发现,IL-10水平下降、病程、TG升高、HbA1c水平升高是T2DM患者颈动脉IMT增厚的危险因素。结论:T2DM患者血清IL-10水平明显降低,并且与颈动脉IMT呈明显负相关,提示IL-10降低可能参与了T2DM患者动脉粥样硬化的发生发展,是颈动脉IMT增厚的危险因素之一。
Objective：To study the changes of serum interleukin-10（IL-10） in patients with type 2 diabetes mellitus（T2DM）,and explore the relationship between serum IL-10 and carotid intima-media thickness（IMT）.Methods：A total of 60 patients with T2DM were selected.These patients were further divided into three groups： 20 patients with normal IMT（IMT1.0 mm）,20 patients with higher IMT（1.0 mm≤IMT≤1.2 mm）,20 patients with atherosclerotic plaque（IMT1.2 mm）.20 healthful volunteers from conventional physical people were taken as normal controls.After fasting more than 8 hours overnight,10 ml blood sample were collected from the elbow vein and separated routinely.Serum IL-10 levels were measured by enzyme-linked immunosorbent assay（ELISA）,OGTT were taken and fasting blood glucose,insulin,blood lipid and hemoglobin A1c（HbA1c） were detected.Height,body weight,waist circumference（WC） were measured and body mass index（BMI）,HOMA-IR were calculated.The data were ananlyzed by ststistical software SPSS 13.0 version.Results：The value of carotid IMT were significantly increased in patients with T2DM compared with normal controls（P〈0.01）,even in patients with normal IMT（P〈0.05）.The levels of serum IL-10 in patients with T2DM reduced obviously compared to normal controls（P〈0.01）,even in patients with normal IMT（P=0.012）.A correlation analysis showed that there were remarkable negative correlation between IL-10 and IMT,BMI,WC,FBG,HbA1c,TC,TG,LDL-C,HOMA-IR,more significant with IMT（r=-0.74,P〈0.01）.With logistic regression analysis,the lower serum IL-10,extension of diabetic course,higher TG and HbA1c were risk factors for the increase IMT.Conclusion：Serum concentrations of IL-10 decreased significantly in patients with T2DM,negatively correlated with the value of carotid IMT.These results indicated that IL-10 may take part in the development of artherosclerosis in patients with T2DM,and lower level of IL-10 is an important risk factor for the increase IMT.
出处
《沈阳医学院学报》
2011年第2期72-76,共5页
Journal of Shenyang Medical College
