血液及骨骼肌免疫状况对老年胰岛素抵抗及甲状腺功能的影响

发布时间：2018-07-02 20:59

本文选题：免疫 + 胰岛素抵抗　；参考：《中国老年学杂志》2016年02期

【摘要】：目的探讨老年2型糖尿病(T2DM)患者外周血液及骨骼肌免疫状态对胰岛素抵抗(IR)及甲状腺功能的影响及相关性。方法 60例新诊断老年T2DM患者,采用稳态模型计算胰岛素抵抗指数(HOMA-IR),同时检测外周血免疫球蛋白(Ig)A、IgG、IgE、IgM、补体C3、补体C4及甲状腺功能最敏感指标促甲状腺激素(TSH)水平,观察HOMA-IR和TSH与外周血免疫水平的相关性;30例患者行三角肌活检并行免疫组化检测IgA、IgG、IgM、C1q、C3c、C4c表达情况,并根据有无免疫复合物沉积情况分组,观察骨骼肌免疫状态对HOMA-IR和TSH水平的影响。结果 HOMAIR与IgA呈正相关(r=0.336,P0.01),TSH水平与补体C4呈负相关(r=-0.364,P0.05),所有患者骨骼肌镜下病理均有肌营养不良表现,18例患者肌肉组织有免疫复合物沉积,与无免疫复合物组患者相比,其HOMA-IR升高(P0.01),而TSH水平降低(P0.05)。结论老年T2DM患者免疫状态与IR及甲状腺功能有强相关性,骨骼肌免疫表达状况对老年T2DM患者IR及甲状腺功能有重要影响,提示免疫是老年T2DM患者IR及甲状腺功能异常的原因之一。
[Abstract]:Objective to investigate the effects of peripheral blood fluid and skeletal muscle immunity on insulin resistance (IR) and thyroid function in elderly patients with type 2 diabetes mellitus (T2DM). Methods the homeostasis model was used to calculate the insulin resistance index (HOMA-IR) in 60 newly diagnosed elderly patients with T2DM. The levels of IgM, C _ 3, C _ 4 and thyrotropin (TSH) in peripheral blood immunoglobulins (Ig) were measured. The correlation between HOMA-IR and TSH and peripheral blood immune level was observed. The expression of IgMA-IR and TSH was detected by immunohistochemistry in 30 patients with deltoid muscle biopsy. The effect of immune state of skeletal muscle on the levels of HOMA-IR and TSH was observed according to whether there was immune complex deposition or not. Results there was a positive correlation between HOMAIR and IgA (r = 0.336, P 0.01). The level of TSH was negatively correlated with complement C4 (r = 0.364, P 0.05). All the patients showed muscular dystrophy under endoscopes, and 18 patients with muscular dystrophy had immune complex deposition in muscle tissue, compared with those without immune complex. Its HOMA-IR increased (P0.01), while the level of TSH decreased (P0.05). Conclusion the immune status of elderly patients with T2DM has strong correlation with IR and thyroid function. The expression of skeletal muscle immunity has an important effect on IR and thyroid function in elderly patients with T2DM. It is suggested that immunity is one of the causes of IR and thyroid dysfunction in elderly patients with type 2 DM.
【作者单位】：右江民族医学院附属医院;暨南大学第一临床医学院;
【基金】：广西卫生厅科研项目基金资助(No.S201218-02)
【分类号】：R587.1

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