Urbanovych Alina, Suslyk Galyna
Department Of Endocrinology, Lviv Danylo Halytskyi National Medical University, Lviv, Ukraine.
Wiad Lek. 2018;71(6):1169-1174.
Introduction: The relationship between glycaemic control in type 2 diabetes and the risk of its complications has been proven in many studies. However, the role of adipose tissue hormones and non-specific inflammatory mediators in type 2 diabetes compensation has not been studied completely. The aim: To evaluate the correlation between the content of selected adipose tissue hormones and mediators of nonspecific inflammation, depending on the glycemic control in type 2 diabetes.
Materials and methods: the study has been focused on the analysis of contents and correlations between leptin, resistin, IL-2, IL-6, TNF-α in 305 patients with type 2 diabetes, who were divided into the following groups (according to their glycemic control): group 1 - with optimal glycaemic control (HbA1c ≤ 7%), group 2 - with suboptimal glycaemic control (HbA1c 7.1-8%), and group 3 - with poor glycaemic control (HbA1c ≥ 8.1%).
Results: the group of type 2 diabetic patients with poor glycaemic control showed a higher resistin level compared with the patients with optimal (+29.43%; <0.05) and suboptimal glycaemic control (+33.45%, < 0.05). Statistically, when comparing groups of type 2 diabetic patients with the different glycaemic control we have noticed no significant changes in the leptin concentration (all > 0.05). The level of circulating insulin was significantly lower in the group of type 2 diabetic patients with poor glycemic control of diabetes, compared to those with suboptimal glycaemic control (-20.87%; <0.05).
Conclusions: In patients with type 2 diabetes an impaired glycaemic control does not influence the leptin level. Though impaired glycaemic control significantly raises resistin level in the blood serum. Studying the concentration of cytokines (TNF-α, IL-2 and IL-6) in the blood serum of type 2 diabetic patients showed that glycaemic control does not provoke any significant differences in their content. The study has proved that resistin is more closely interconnected to cytokines in case of worsening the diabetes compensation - there has been found a significant positive correlation between the content of TNF-α and resistin in the group with optimal glycaemic control, then between IL-6 and resistin in the group with suboptimal glycaemic control; and in the group with unsatisfactory glycaemic control there has been detected a correlation between TNF-α, IL-2, IL-6 and resistin.
引言：许多研究已证实2型糖尿病患者的血糖控制与其并发症风险之间的关系。然而，脂肪组织激素和非特异性炎症介质在2型糖尿病代偿中的作用尚未得到充分研究。目的：根据2型糖尿病患者的血糖控制情况，评估所选脂肪组织激素含量与非特异性炎症介质之间的相关性。
材料与方法：本研究聚焦于分析305例2型糖尿病患者体内瘦素、抵抗素、白细胞介素-2（IL-2）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）的含量及其相关性。这些患者被分为以下几组（根据血糖控制情况）：第1组——血糖控制理想（糖化血红蛋白[HbA1c]≤7%）；第2组——血糖控制欠佳（HbA1c 7.1 - 8%）；第3组——血糖控制差（HbA1c≥8.1%）。
结果：血糖控制差的2型糖尿病患者组其抵抗素水平高于血糖控制理想组（升高29.43%；P<0.05）和血糖控制欠佳组（升高33.45%，P<0.05）。统计学上，比较不同血糖控制情况的2型糖尿病患者组时，我们发现瘦素浓度无显著变化（均P>0.05）。血糖控制差的2型糖尿病患者组的循环胰岛素水平显著低于血糖控制欠佳组（降低20.87%；P<0.05）。
结论：在2型糖尿病患者中，血糖控制受损不影响瘦素水平。尽管血糖控制受损会显著提高血清抵抗素水平。对2型糖尿病患者血清中细胞因子（TNF-α、IL-2和IL-6）浓度的研究表明，血糖控制对其含量无显著影响。研究证明，在糖尿病代偿恶化时，抵抗素与细胞因子联系更为紧密——在血糖控制理想组中发现TNF-α含量与抵抗素之间存在显著正相关，在血糖控制欠佳组中IL-6与抵抗素之间存在显著正相关；在血糖控制不满意组中检测到TNF-α、IL-2、IL-6与抵抗素之间存在相关性。
