Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital, Lausanne, Switzerland.
Clin Endocrinol (Oxf). 2013 Feb;78(2):232-41. doi: 10.1111/j.1365-2265.2012.04384.x.
The associations between inflammation, diabetes and insulin resistance remain controversial. Hence, we assessed the associations between diabetes, insulin resistance (using HOMA-IR) and metabolic syndrome with the inflammatory markers high-sensitive C-reactive protein (hs-CRP), interleukin-1 beta (IL-1β), interleukin-6 (IL-6) and tumour necrosis factor-α (TNF-α).
Cross-sectional study.
Two thousand eight hundred and eighty-four men and 3201 women, aged 35-75, participated in this study.
C-reactive protein was assessed by immunoassay and cytokines by multiplexed flow cytometric assay. In a subgroup of 532 participants, an oral glucose tolerance test (OGTT) was performed to screen for impaired glucose tolerance (IGT).
IL-6, TNF-α and hs-CRP were significantly and positively correlated with fasting plasma glucose (FPG), insulin and HOMA-IR. Participants with diabetes had higher IL-6, TNF-α and hs-CRP levels than participants without diabetes; this difference persisted for hs-CRP after multivariate adjustment. Participants with metabolic syndrome had increased IL-6, TNF-α and hs-CRP levels; these differences persisted after multivariate adjustment. Participants in the highest quartile of HOMA-IR had increased IL-6, TNF-α and hs-CRP levels; these differences persisted for TNF-α and hs-CRP after multivariate adjustment. No association was found between IL-1β levels and all diabetes and insulin resistance markers studied. Finally, participants with IGT had higher hs-CRP levels than participants with a normal OGTT, but this difference disappeared after controlling for body mass index (BMI).
We found that subjects with diabetes, metabolic syndrome and increased insulin resistance had increased levels of IL6, TNF-α and hs-CRP, while no association was found with IL-1β. The increased inflammatory state of subjects with IGT is partially explained by increased BMI.
炎症、糖尿病和胰岛素抵抗之间的关系仍存在争议。因此，我们评估了糖尿病、胰岛素抵抗（使用 HOMA-IR）和代谢综合征与炎症标志物高敏 C 反应蛋白（hs-CRP）、白细胞介素-1β（IL-1β）、白细胞介素-6（IL-6）和肿瘤坏死因子-α（TNF-α）之间的关系。
横断面研究。
本研究共纳入 2884 名男性和 3201 名 35-75 岁的女性。
采用免疫法测定 C 反应蛋白，采用多重流式细胞术测定细胞因子。在 532 名参与者的亚组中，进行口服葡萄糖耐量试验（OGTT）筛查糖耐量受损（IGT）。
IL-6、TNF-α 和 hs-CRP 与空腹血糖（FPG）、胰岛素和 HOMA-IR 呈显著正相关。患有糖尿病的参与者的 IL-6、TNF-α 和 hs-CRP 水平高于没有糖尿病的参与者；在进行多变量调整后，hs-CRP 仍存在差异。患有代谢综合征的参与者的 IL-6、TNF-α 和 hs-CRP 水平升高；在进行多变量调整后，这些差异仍然存在。HOMA-IR 最高四分位的参与者的 IL-6、TNF-α 和 hs-CRP 水平升高；在进行多变量调整后，TNF-α 和 hs-CRP 仍存在差异。IL-1β 水平与所有研究的糖尿病和胰岛素抵抗标志物均无关联。最后，与 OGTT 正常的参与者相比，IGT 参与者的 hs-CRP 水平更高，但在控制体重指数（BMI）后，这种差异消失。
我们发现，患有糖尿病、代谢综合征和胰岛素抵抗增加的受试者的 IL6、TNF-α 和 hs-CRP 水平升高，而与 IL-1β 无关联。IGT 受试者的炎症状态增加部分由 BMI 增加解释。
