不同糖耐量人群sCD40L、VCAM-1、IL-6、TNF-α mRNA异常表达与血管内皮功能关系研究

发布时间：2018-02-09 00:41

本文关键词： 2型糖尿病可溶性CD40配体血管内皮功能 VCAM-1　出处：《青岛大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的:检测不同糖耐量水平与血清可溶性CD40配体(s CD40L)以及高敏C-反应蛋白(CRP)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平变化及与血管内皮功能的关系。方法:分别选取正常对照组(NC组)、糖调节异常组(IGR组)、2型糖尿组(T2DM组)、T2DM伴血管病变组(T2DM+VC组)各30例。1 RT-PCR法检测各组单个核细胞s CD40L、IL-6、TNF-α、VCAM-1m RNA表达。2用酶联免疫法(ELISA)检测血清s CD40L、IL-6、TNF-α、VCAM-1。3 C反应蛋白(CRP)用特定蛋白测定仪免疫散射比浊法检测。4用彩超多普勒测定肱动脉内皮依赖性舒张功能(FMD),含服硝酸甘油后肱动脉内皮依赖性舒张功能(NID)检测;检测颈动脉内膜-中层厚度(MIT)与心脏结构参数。5碱性磷酸酶标记的化学发光免疫分析检测空腹血清胰岛素(FINS)含量。6生物化学指标总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)用贝克曼LX20全自动生物化学分析仪检测。7高效液相色谱法检测糖化血红蛋白(Hb Al C)。8稳态模型评估法计算胰岛素抵抗指数(HOMA-IR)=(FPG×FINS)/22.5。结果:①RT-PCR检测s CD40L、IL-6、TNF-α、VCAM-1m RNA表达,与IGR组相比,T2DM+VC组表达量明显增加,T2DM组次之。②ELISA与特定蛋白测定仪检测IGR组、T2DM组、T2DM+VC组患者血清s CD40L、CRP、IL-6、TNF-α、VCAM-1水平均高于NC组,各组间差异有统计学意义(P均0.05)。③随着各组s CD40L及各炎症因子CRP、IL-6、TNF-α水平增高,血清VCAM-1及内皮功能指标IMT、IVST、LVPWT升高,FMD、NID值下降。其中,IVST、LVPWT在T2DM组及T2DM+VC组较其余组有统计学意义(P0.05),而VCAM-1、IMT、FMD、NID各组间差异均有统计学意义(P0.05)。④s CD40L与CRP、IL-6、TNF-α、空腹血糖(FPG)、Hb Alc、VCAM-1、IMT呈正相关(P均0.05)。结论:①糖尿病前期s CD40L、CRP、IL-6、TNF-α水平已明显升高,且糖尿病前期糖调节异常组、T2DM组、T2DM+VC组各表达量呈明显递增趋势,s CD40L、CRP、IL-6、TNF-α等一起参与了糖尿病的发生发展,在T2DM自然病程中可能发挥一定作用。②高水平s CD40L、CRP、IL-6、TNF-α可能与血管内皮功能损害有关,与T2DM发生血管病变的危险性增高相关。
[Abstract]:Objective: to detect the relationship between serum soluble CD40 ligand CD40L), serum soluble CD40 ligand CD40L, and the levels of Gao Min C- reactive protein, IL-6, tumor necrosis factor- 伪 TNF- 伪, and their relationship with vascular endothelial function. 30 cases of T2DM with VCAM-1.3 C-reactive protein were detected by RT-PCR method. The expression of sCD40LTNF- 伪 VCAM-1m RNA in each group was detected by enzyme linked immunosorbent assay (ELISA-EISAs), and the expression of SCD40L- TNF- 伪 VCAM-1m RNA was detected by Elisa in 30 patients with T2DM complicated with vascular disease and 30 patients with T2DM with vascular disease. The expression of sCD40L- TNF- 伪 VCAM-1m RNA in each group was detected by enzyme-linked immunosorbent assay (Elisa). The endothelium-dependent dilatation function of brachial artery was measured by color Doppler ultrasound and the endothelium-dependent diastolic function of brachial artery was detected by using nitroglycerin. Detection of carotid intima-media thickness (mitt) and chemiluminescence immunoassay of heart structural parameter 5. 5 alkaline phosphatase for detection of fasting serum insulin (fins) content 6. 6 biochemistry index total cholesterol TCX, triglyceride TGG, low density lipids. High density lipoprotein cholesterol (HDL-C) was detected by Beckman LX20 automatic biochemistry analyzer. 7. High performance liquid chromatography (HPLC) was used to detect glycosylated hemoglobin (HbAlC8). The homeostasis model evaluation method was used to calculate the insulin resistance index (HOMA-IRN). The expression of TNF- 伪 -VCAM-1m RNA was detected by RT-PCR. Compared with IGR group, the expression of T2DM VC group was significantly higher than that of IGR group. 2ELISA and specific protein assays were used to detect the serum levels of serum sCD40L- 6TNF- 伪 and VCAM-1 in IGR patients with T2DM group and T2DM VC group (P < 0.05), and the results showed that the level of serum sCD40L-, IL-6, TNF- 伪 and VCAM-1 in T2DM group was significantly higher than that in NC group. There were significant differences among the three groups (P < 0.05). With the increase of the levels of s CD40L and the inflammatory factor CRP6, TNF- 伪, there was no significant difference between the two groups. Serum VCAM-1 and endothelial function index IMTIVST-LVPWT increased and FMD-NID decreased, among them, IVST-LVPWT was significantly higher in T2DM group and T2DM VC group than that in other groups (P 0.05), while VCAM-1 IMT FMDN NID was significantly different from CRPIL-6TNF- 伪, and fasting blood glucose (FBG) was positively correlated with HbAlcCCAM-1IMT (P 0.05) and FMD-NID (P < 0.05). The level of FMD-NID was significantly higher in IVST-LVPWT than that in T2DM group and T2DM VC group (P < 0.01), but there was a significant difference between VCAM-1IMT and VCAM-1IMT in VCAM-1IMT group (P < 0.05). Conclusion the level of IL-6 TNF- 伪 in the prediabetic patients with prediabetes was significantly higher than that in the control group, and the level of IL-6 TNF- 伪 in CRP was significantly increased. Moreover, the expression of T2DM VC in prediabetic patients with abnormal glucose regulation showed a significant increasing trend, such as CD40L, CRP, IL-6, TNF- 伪, and so on, which participated in the occurrence and development of diabetes. It may play a certain role in the natural course of T2DM. 2. The high level of sCD40L, CRP, IL-6, TNF- 伪 may be related to the damage of vascular endothelial function, and may be related to the increased risk of vascular lesions in T2DM.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R587.1

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