Mavridis G, Souliou E, Diza E, Symeonidis G, Pastore F, Vassiliou A M, Karamitsos D
B' Department of Internal Medicine, General Hospital O Agios Dimitrios, Thessaloniki, Greece.
Nutr Metab Cardiovasc Dis. 2008 Sep;18(7):471-6. doi: 10.1016/j.numecd.2007.02.013. Epub 2007 Oct 31.
An association between type 2 diabetes mellitus and inflammation has been described in several studies. The aim of this study was to search for the presence of low-grade inflammation in a special group of insulin-treated patients with type 2 diabetes, and to investigate a possible correlation between inflammation and obesity, glucose homeostasis and insulin requirement (IU insulin/kg body weight, BW).
We studied 85 subjects with type 2 diabetes that were receiving insulin treatment (group A) and 32 receiving sulfonylurea treatment (group B), and 57 subjects without diabetes (group C). Interleukin-6 (IL-6), tumour necrosis factor-alpha (TNF-alpha), and the soluble TNF-alpha receptors sTNFR-60 and sTNFR-80 were measured in serum samples taken from all patients.
The mean serum cytokine levels in group A vs. group B were: IL-6, 8.54+/-11 vs. 2.71+/-1.9 pg/ml (p=0.000); TNF-alpha, 14.33+/-24 vs. 5.12+/-15 pg/ml (p=0.016); sTNFR60, 3.9+/-2.8 vs. 2.36+/-1.4 ng/ml (p=0.000); and sTNFR80, 11.9+/-7 vs. 9.4+/-6 ng/ml (p=0.080). The mean serum cytokine levels in group A vs. group C were: IL-6, 8.54+/-11 vs. 4.74+/-7 pg/ml (p=0.017); TNF-alpha, 14.33+/-24 vs. 5.94+/-3.4 pg/ml (p=0.003); sTNFR60, 3.9+/-2.8 vs. 2.54+/-1.4 ng/ml (p=0.000); and sTNFR80, 11.9+/-7 vs. 10.85+/-8 ng/ml (p=0.470). A positive association between waist circumference and IL-6 (r=0.165, p=0.030) and sTNFR-60 (r=0.276, p=0.000) was detected. A significant correlation coefficient was observed between haemoglobin A1c (HbA1c) and both IL-6 (r=0.278, p=0.000) and sTNFR-60 (r=0.293, p=0.000), when the groups were studied as one. No correlation between inflammation and units of insulin/kg BW was found. In conclusion, low-grade chronic inflammation, as estimated by the relative levels of inflammatory cytokines, was present in patients with type 2 diabetes that were receiving insulin treatment, with significantly higher cytokine levels recorded compared to sulfonylurea-treated patients. In addition, an association between inflammation and both obesity and glucose homeostasis was detected.
多项研究已描述了2型糖尿病与炎症之间的关联。本研究旨在探寻接受胰岛素治疗的2型糖尿病特殊患者群体中是否存在低度炎症，并调查炎症与肥胖、葡萄糖稳态及胰岛素需求量（胰岛素国际单位/千克体重，BW）之间可能存在的相关性。
我们研究了85例接受胰岛素治疗的2型糖尿病患者（A组）、32例接受磺脲类药物治疗的患者（B组）以及57例无糖尿病的受试者（C组）。检测了所有患者血清样本中的白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）以及可溶性TNF-α受体sTNFR-60和sTNFR-80。
A组与B组血清细胞因子平均水平如下：IL-6，8.54±11对2.71±1.9皮克/毫升（p = 0.000）；TNF-α，14.33±24对5.12±15皮克/毫升（p = 0.016）；sTNFR60，3.9±2.8对2.36±1.4纳克/毫升（p = 0.000）；sTNFR80，11.9±7对9.4±6纳克/毫升（p = 0.080）。A组与C组血清细胞因子平均水平如下：IL-6，8.54±11对4.74±7皮克/毫升（p = 0.017）；TNF-α，14.33±24对5.94±3.4皮克/毫升（p = 0.003）；sTNFR60，3.9±2.8对2.54±1.4纳克/毫升（p = 0.000）；sTNFR80，11.9±7对10.85±8纳克/毫升（p = 0.470）。检测到腰围与IL-6（r = 0.165，p = 0.030）和sTNFR-60（r = 0.276，p = 0.000）呈正相关。将所有组作为一个整体研究时，观察到糖化血红蛋白（HbA1c）与IL-6（r = 0.278，p = 0.000）和sTNFR-60（r = 0.293，p = 0.000）之间存在显著相关系数。未发现炎症与胰岛素/千克体重单位之间存在相关性。总之，通过炎症细胞因子相对水平评估，接受胰岛素治疗的2型糖尿病患者存在低度慢性炎症，与接受磺脲类药物治疗的患者相比，细胞因子水平显著更高。此外，检测到炎症与肥胖及葡萄糖稳态均有关联。
