血清骨钙素、白细胞介素-18在不同糖耐量人群的变化及其与2型糖尿病颈动脉粥样硬化的关系

发布时间：2018-06-23 14:23

本文选题：糖尿病 + 型　；参考：《中国循环杂志》2017年07期

【摘要】：目的:比较血清骨钙素、白细胞介素-18(IL-18)在不同糖耐量人群的变化,并探讨其与2型糖尿病颈动脉粥样硬化的关系。方法:将140例研究对象根据口服葡萄糖耐量试验(OGTT)结果分成三组:正常对照组50例,糖尿病前期组30例,2型糖尿病组60例,2型糖尿病组又分为颈动脉内膜中层厚度(IMT)正常亚组26例、IMT增厚亚组34例。各组均测IMT、血清骨钙素、IL-18及糖化血红蛋白(HbA1c)、空腹血糖、OGTT 2h血糖(2hPG)、总胆固醇、甘油三酯、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)等,并计算体重指数、胰岛素抵抗(IR)指数(HOMA-IR)、胰岛细胞功能指数(HOMA-β)。应用Pearson相关性及多元线性逐步回归模型对各指标进行分析。结果:从正常对照组到糖尿病前期组,再到2型糖尿病组,骨钙素逐渐降低(P均0.05),IL-18则逐渐上升(P均0.05)。骨钙素与HbA1c、空腹血糖、2hPG、HOMA-IR、总胆固醇、颈动脉IMT均呈负相关(r分别为-0.426、-0.582、-0.489、-0.456、-0.451、-0.559,P均0.05),与HOMA-β呈正相关(r=0.439,P0.05)。IL-18与体重指数、HbA1c、空腹血糖、2hPG、HOMA-IR、总胆固醇、甘油三酯、LDL-C、颈动脉IMT均呈正相关(r分别为0.395、0.693、0.880、0.715、0.667、0.734、0.326、0.471、0.857,P均0.05),与HOMA-β呈负相关(r=-0.678,P0.05)。2型糖尿病组中颈动脉IMT与IL-18、空腹血糖、HOMA-IR、总胆固醇、甘油三酯均呈正相关(r分别为0.817、0.415、0.356、0.396、0.362,P均0.05),与骨钙素呈负相关(r=-0.588,P0.05)。多元线性逐步回归分析显示,IL-18、骨钙素、总胆固醇、空腹血糖是颈动脉IMT的独立影响因素(回归系数分别为0.013、-0.011、0.044、0.044,P均0.05)。结论:血清骨钙素、IL-18参与糖脂代谢的过程,其水平与2型糖尿病颈动脉粥样硬化的发生和发展密切相关。
[Abstract]:Aim: to compare the changes of serum osteocalcin and interleukin-18 (IL-18) in patients with different glucose tolerance (GTT) and to explore their relationship with carotid atherosclerosis in type 2 diabetes mellitus. Methods: according to the results of oral glucose tolerance test (OGTT), 140 subjects were divided into three groups: normal control group (n = 50), normal control group (n = 50) and control group (n = 50). Thirty patients with type 2 diabetes were divided into two groups: normal carotid intima-media thickness (IMT) group (n = 26), IMT thickening subgroup (n = 34), and normal carotid artery intima-media thickness (IMT) subgroup (n = 26). IMT, serum osteocalcin IL-18 and glycosylated hemoglobin (HbA1c), fasting blood glucose OGTT 2h glucose (2hPG), total cholesterol, triglyceride, low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) were measured, and body mass index was calculated. Insulin resistance (IR) index (HOMA-IR), islet cell function index (HOMA- 尾). Pearson correlation and multiple linear stepwise regression models were used to analyze the indexes. Results: from normal control group to prediabetic group and then to type 2 diabetes group, osteocalcin gradually decreased (P 0.05) and IL-18 gradually increased (P 0.05). Osteocalcin was negatively correlated with HbA1c, fasting blood glucose 2hPGHPGHOMA-IRR, total cholesterol, carotid IMT (r = -0.426) -0.582U -0.489U -0.456U -0.451U -0.559U P 0.05, and positively correlated with HOMA- 尾 (r 0.439P 0.05) .IL-18 was positively correlated with body mass index (BMI) HbA1c, fasting blood glucose 2hPGHOMA-IRT, total cholesterol, total cholesterol. There was a positive correlation between LDL-C and IMT in carotid artery (r = 0.395U 0.6933n 0.8800.667U 0.7340.326U 0.4710.857U P 0.05), and a negative correlation between IMT and HOMA- 尾 (r-0.678P0.05). 2. In type 2 diabetes mellitus group, IMT was positively correlated with IL-18, fasting blood glucose, HOMA-IRT, total cholesterol, triglyceride (r = 0.8170.0.4150.3560.3960.362P 0.05, respectively), and negatively correlated with osteocalcin (r = 0.588P 0.05). Multiple linear stepwise regression analysis showed that IL-18, osteocalcin, total cholesterol and fasting blood glucose were independent influencing factors of carotid IMT (regression coefficients were 0.013 ~ 0.011 ~ 0.04 ~ 0.04 ~ 0.04 ~ 0.044). Conclusion: serum osteocalcin IL-18 is involved in the process of glycolipid metabolism, and its level is closely related to the occurrence and development of carotid atherosclerosis in type 2 diabetes mellitus.
【作者单位】：蚌埠医学院第一附属医院内分泌科;
【基金】：安徽省教育厅自然科学研究一般项目(KJ2015B055by) 蚌埠医学院自然科学基金(BYKY1454)
【分类号】：R543;R587.2

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