Makino T, Noguchi Y, Yoshikawa T, Doi C, Nomura K
Yokohama City University, School of Medicine, First Department of Surgery, Yokohama, Japan.
Br J Surg. 1998 Dec;85(12):1658-62. doi: 10.1046/j.1365-2168.1998.00938.x.
The mechanism of insulin resistance in patients with cancer is not clear. This study was conducted to evaluate the possible role of circulating cytokines in inducing insulin resistance in patients with cancer.
Twenty-three patients with a variety of cancers were studied, including one patient with oesophageal cancer, 12 with gastric cancer, four with colon cancer and six with lung cancer. Six normal volunteers served as controls. Insulin resistance was evaluated by euglycaemic hyperinsulinaemic glucose clamp with a high physiological insulin concentration of 100 microunits/ml. Metabolized glucose, the M value, was compared between patients with cancer and controls. Serum concentrations of interleukin (IL) 6 and other cytokines (tumour necrosis factor (TNF) alpha, IL-8 and IL-10) were measured by enzyme-linked immunosorbent assay.
The mean(s.d.) M value for patients with cancer (5.47(1.59) mg per kg per min) was significantly lower than that for controls (8.23(0.79) mg per kg per min) (P< 0.001). There was no relationship between the M value and degree of body-weight loss. Serum IL-6 concentration was measurable in eight of 23 patients: four with lung cancer, two with gastric cancer, and one each with oesophageal and colon cancer. None of the controls had a measurable serum IL-6 concentration. There was no significant relationship between serum IL-6 concentration and body-weight loss. TNF-alpha was undetectable in the serum of both patients with cancer and controls. Serum IL-8 and IL-10 were detected in seven and one of 23 patients respectively. These cytokines were not detected in the serum of controls. The M value was significantly smaller in those with measurable serum IL-6 (4.01(1.22) mg per kg per min) than in those with no measurable IL-6 (6.26(1.16) mg per kg per min) (P< 0.001). IL-6 and IL-8 levels were raised more frequently in the same patient but there was no significant relationship between IL-8 and M values.
These results may suggest that IL-6 is related to insulin resistance in patients with cancer.
癌症患者胰岛素抵抗的机制尚不清楚。本研究旨在评估循环细胞因子在诱导癌症患者胰岛素抵抗中可能发挥的作用。
对23例患有各种癌症的患者进行了研究，其中包括1例食管癌患者、12例胃癌患者、4例结肠癌患者和6例肺癌患者。6名正常志愿者作为对照。采用高生理胰岛素浓度100微单位/毫升的正常血糖高胰岛素葡萄糖钳夹技术评估胰岛素抵抗。比较癌症患者和对照组的代谢葡萄糖（M值）。通过酶联免疫吸附测定法测量血清白细胞介素（IL）-6和其他细胞因子（肿瘤坏死因子（TNF）-α、IL-8和IL-10）的浓度。
癌症患者的平均（标准差）M值（5.47（1.59）毫克/千克/分钟）显著低于对照组（8.23（0.79）毫克/千克/分钟）（P<0.001）。M值与体重减轻程度之间无相关性。23例患者中有8例可检测到血清IL-6浓度：4例肺癌患者、2例胃癌患者、1例食管癌患者和1例结肠癌患者。对照组中无一例可检测到血清IL-6浓度。血清IL-6浓度与体重减轻之间无显著相关性。癌症患者和对照组的血清中均未检测到TNF-α。23例患者中分别有7例和1例检测到血清IL-8和IL-10。对照组血清中未检测到这些细胞因子。血清IL-6可检测的患者的M值（4.01（1.22）毫克/千克/分钟）显著低于血清IL-6不可检测的患者（6.26（1.16）毫克/千克/分钟）（P<0.001）。同一患者中IL-6和IL-8水平升高更为常见，但IL-8与M值之间无显著相关性。
这些结果可能提示IL-6与癌症患者的胰岛素抵抗有关。
