IL-6、TNF-α和Hs-CRP对腹腔镜胆囊切除术后或开放性疝修补术后患者胰岛素敏感性的影响。
Influence of IL-6, TNF-α and Hs-CRP on Insulin Sensitivity in Patients after Laparoscopic Cholecystectomy or Open Hernia Repair.
作者信息
Micić Dušan, Lalić Nebojša, Djukić Vladimir, Stanković Sanja, Trajković Goran, Oluić Branislav, Polovina Snežana
机构信息
Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
Clinic for Emergency Surgery, Emergency Center, Clinical Center of Serbia, Belgrade, Serbia.
出版信息
J Med Biochem. 2018 Jul 1;37(3):328-335. doi: 10.1515/jomb-2017-0043. eCollection 2018 Jul.
BACKGROUND
The aim of this study was to investigate the influence of IL-6, TNF-α and hs-CRP on insulin sensitivity during postoperative follow-up in patients with laparoscopic cholecystectomy (LC) or open hernia repair (OHR).
METHODS
65 patients were studied: after laparoscopic cholecystectomy (LC; n=40) or open hernia repair (OHR; n=25). Glucose, insulin, hs-CRP, IL-6 and TNF-a were determined at day 0 (before the operation) and at days 1, 3 and 7 (after the operation).
RESULTS
There were no difference between LC and OHR groups concerning age, BMI, glucose, insulin, hs-CRP, IL-6 and TNF-α at day 0. hs-CRP increased at day 1, 3 and 7 vs. day 0 (p<0.0005), without difference between groups (p=0.561). IL-6 increased at day 1 and day 3 vs. day 0 (p<0.005). IL-6 was higher at day 1 in OHR group in comparison with LC group (p=0.044). There were no differences in TNF-a levels between LC and OHR groups (p=0.056). There was increase of HOMA-IR at day 1, 3 and 7 vs. day 0 (p<0.0005) in both groups. Significantly higher increase of HOMA-IR was in OHR group compared with LC group at day 1 (p=0.045). There was a positive correlation between hs-CRP and HOMA-IR (r=0.46; p=0.025) and between IL-6 and HOMA-IR at day 1 in OHR group (r=0.44; p=0.030).
CONCLUSIONS
Significantly higher HOMA-IR was found in OHR group compared with LC. Positive correlation between hs-CRP and IL-6 with HOMA-IR in OHR group at day 1, indicate possible influence of this mediators on impairment of insulin sensitivity.
背景
本研究旨在调查白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）和高敏C反应蛋白（hs-CRP）对接受腹腔镜胆囊切除术（LC）或开放式疝修补术（OHR）患者术后随访期间胰岛素敏感性的影响。
方法
对65例患者进行研究：其中40例行腹腔镜胆囊切除术（LC），25例行开放式疝修补术（OHR）。在第0天（手术前）以及第1、3和7天（手术后）测定血糖、胰岛素、hs-CRP、IL-6和TNF-α。
结果
第0天，LC组和OHR组在年龄、体重指数、血糖、胰岛素、hs-CRP、IL-6和TNF-α方面无差异。与第0天相比，第1、3和7天hs-CRP升高（p<0.0005），组间无差异（p=0.561）。与第0天相比，第1天和第3天IL-6升高（p<0.005）。OHR组第1天的IL-6高于LC组（p=0.044）。LC组和OHR组的TNF-α水平无差异（p=0.056）。两组第1、3和7天的稳态模型评估胰岛素抵抗（HOMA-IR）均较第0天升高（p<0.0005）。第1天OHR组的HOMA-IR升高幅度显著高于LC组（p=0.045）。OHR组第1天hs-CRP与HOMA-IR之间存在正相关（r=0.46；p=0.025），IL-6与HOMA-IR之间也存在正相关（r=0.44；p=0.030）。
结论
与LC组相比，OHR组的HOMA-IR显著更高。OHR组第1天hs-CRP和IL-6与HOMA-IR之间的正相关表明这些介质可能对胰岛素敏感性受损有影响。
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