初诊2型糖尿病患者TLR4水平与糖脂代谢及慢性炎症的相关性

目的:探讨初诊2型糖尿病患者血清Toll样受体4(Toll-like receptor 4,TLR4)水平变化及其与糖脂代谢和慢性炎症的相关性。方法:选取2018年9月至2019年1月于吉林大学第二医院内分泌科就诊的150例初诊2型糖尿病患者及45例正常体检人员,将所选研究对象分为正常对照组(NC组,n=45),2型糖尿病组(T2DM组,n=85),2型糖尿病合并超重或肥胖组(T2DM+OB组,n=65)。统计并检测各组年龄,性别,病程,BMI,三酰甘油(triglyceride,TG),总胆固醇(total cholesterol,TC),高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C),低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C),空腹血糖(fasting plasma glucose,FPG),糖化血红蛋白(glycosylated hemoglobin,HbA1c),空腹胰岛素(fasting insulin,FINS),稳态胰岛素评价指数(homeostasis modeall assessment of insulin resistance,HOMA-IR),超敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP)。ELISA检测血清TLR4水平。3组间比较采用方差分析;应用Pearson相关分析血清TLR4与BMI,TG,LDL-C,HOMA-IR,hs-CRP的相关性;logistic回归分析2型糖尿病合并超重或肥胖的独立危险因素等。结果:NC组、T2DM组、T2DM+OB组的TG,LDL-C,FPG,HbA1c,FINS,HOMA-IR,hs-CRP,TLR4水平逐渐升高,3组间差异有统计学意义(P<0.05)。相关性分析显示:血清TLR4水平与BMI,TG,LDL-C,HOMA-IR及hs-CRP呈正相关。Logistic回归分析显示:LDL-C,HOMA-IR,hs-CRP,TLR4是2型糖尿病合并肥胖或超重的独立危险因素。结论:初诊2型糖尿病患者血清TLR4水平升高,其合并超重或肥胖的风险越大。

Correlation between serum Toll-like receptor 4 and glucose and lipid metabolism and chronic inflammation in newly diagnosed type 2 diabetic patients

Objective: To explore the relationship between the serum levels of Toll-like receptor 4(TLR4) and glucose and lipid metabolism and chronic inflammation in patients with newly diagnosed type 2 diabetes mellitus. Methods: A total of 150 newly diagnosed type 2 diabetic patients and 45 normal controls in Department of Endocrinology of Second Hospital of Jilin University from September 2018 to January 2019 were enrolled. Th ey were divided into three groups: a normal control group(NC group, n=45), a type 2 diabetes group(T2 DM group, n=85), and a type 2 diabetes with overweight or obesity group(T2 DM + OB group, n=65). Data including age, gender, disease duration, BMI, triglyceride(TG), total cholesterol(TC), high density lipoprotein cholesterol(HDL-C), low density lipoprotein cholesterol(LDL-C), fasting plasma glucose(FPG), glycosylated hemoglobin(HbA1 c), fasting insulin(FINS), homeostasis modeall assessment of insulin resistance(HOMA-IR), and high-sensitivity C-reactive protein(hs-CRP) were determined. The serum levels of TLR4 were determined by ELISA. The comparison between groups was tested by analysis of variance;correlation between serum TLR4 and BMI, TG, LDL-C, HOMA-IR and hs-CRP was performed by Pearson correlation analysis;logistic regression was used to analyze the independent risk factors of type 2 diabetes with overweight or obesity. Results: TG, LDL-C, FPG, HbA1 c, FINS, HOMA-IR, hs-CRP and TLR4 in the NC group, the T2 DM group and the T2 DM+OB group gradually increased, and the difference among the 3 groups was statistically significant(P<0.05). There was a positive correlation between TLR4 with BMI, TG, LDL-C, HOMA-IR, and hs-CRP. Logistic stepwise analysis showed that LDL-C, HOMA-IR, hs-CRP and TLR4 were independent risk factors of type 2 diabetes with overweight or obesity. Conclusion: Th e higher the level of TLR4 in patients with newly diagnosed type 2 diabetes, the greater the risk of overweight or obesity.