Blüher M, Fasshauer M, Tönjes A, Kratzsch J, Schön M R, Paschke R
Department of Internal Medicine 2, University of Köln, Köln, Germany.
Exp Clin Endocrinol Diabetes. 2005 Oct;113(9):534-7. doi: 10.1055/s-2005-872851.
Abnormal glucose tolerance is associated with subclinical chronic inflammation in patients with type 2 diabetes. The aim of this study was to investigate whether plasma concentrations of inflammatory markers are associated with measures of obesity, insulin sensitivity, and hyperglycemia. IL-6, adiponectin, CRP, and IL-10 plasma concentrations were evaluated in 142 patients with a wide range of obesity, insulin sensitivity and glucose tolerance. In parallel with the impairment of glucose tolerance, there was a significant increase in IL-6, and CRP, and a significant decrease in adiponectin and IL-10 plasma concentrations. There were significant correlations between the plasma concentrations of all inflammatory markers and % body fat, insulin sensitivity, and fasting plasma glucose. However, multivariate linear regression analysis identified insulin sensitivity as determined by glucose infusion rate during the steady state of an euglycemic-hyperinsulinemic clamp as the strongest predictor of adiponectin, CRP, IL-6, and IL-10 plasma concentrations. In addition, fasting plasma glucose was a significant determinant of adiponectin, CRP, and IL-6 plasma concentrations, whereas body fat content was only a significant predictor of CRP plasma concentration. In conclusion, our data suggest that abnormal inflammatory markers in patients with type 2 diabetes are primarily related to decreased insulin sensitivity.
2型糖尿病患者的糖耐量异常与亚临床慢性炎症相关。本研究的目的是调查炎症标志物的血浆浓度是否与肥胖、胰岛素敏感性和高血糖的指标相关。对142例肥胖程度、胰岛素敏感性和糖耐量范围广泛的患者评估了白细胞介素-6(IL-6)、脂联素、C反应蛋白(CRP)和白细胞介素-10(IL-10)的血浆浓度。随着糖耐量受损,IL-6和CRP显著升高,脂联素和IL-10血浆浓度显著降低。所有炎症标志物的血浆浓度与体脂百分比、胰岛素敏感性和空腹血糖之间均存在显著相关性。然而,多变量线性回归分析确定,在正常血糖-高胰岛素钳夹稳态期间由葡萄糖输注率所确定的胰岛素敏感性是脂联素、CRP、IL-6和IL-10血浆浓度的最强预测因素。此外,空腹血糖是脂联素、CRP和IL-6血浆浓度的重要决定因素,而体脂含量仅是CRP血浆浓度的重要预测因素。总之,我们的数据表明,2型糖尿病患者异常的炎症标志物主要与胰岛素敏感性降低有关。