探讨糖尿病前期患者血浆IL-18、PAI-1水平变化与胰岛素抵抗的相关性

目的探讨血浆白细胞介素-18(IL-18)、纤溶酶原激活物抑制物-1(PAI-1)水平变化与Ⅱ型糖尿病发病危险因素的关系.方法 设立健康人对照(NGT)组、糖耐量减低( IGT )组、空腹血糖受损合并糖耐量减低(IFG/IGT)组,每组各100例.测定各受试者血浆 IL-18、PAI-1、血清空腹胰岛素、空腹血糖、餐后2 h血糖,应用稳态模型评估法评价胰岛素抵抗(HOMA-IR).结果 IGT组、IFG/IGT组血浆 IL-18、PAI-1 水平均高于NGT组(P<0.01).IFG/IGT组血浆 IL-18、PAI-1 水平均高于IGT组(P<0.05).相关分析显示IL-18、PAI-1 水平与空腹血糖、餐后2 h血糖、HOMA-IR呈正相关(P<0.01).结论血浆 IL-18、PAI-1 水平升高可能是加重糖尿病前期患者胰岛素抵抗的危险因素;在糖尿病前期,IL-18、PAI-1可能参与了Ⅱ型糖尿病的发生、发展.

Relationship between plasma interleukin-18, plasminogen activator inhibitor-1 levels and insulin resistance in patients with pre-diabetes

Objective To investigate the association between risk factors of type 2 diabetes and the changes of plasma interleukin-18(IL-18), plasminogen activator inhibitor-1(PAI-1) levels.Methods Healthy control(NGT) group (n=100 ),impaired glucose tolerance(IGT) group (n=100 ) and impaired fasting glucose combination impaired glucose tolerance(IFG/IGT) group (n=100 ) were enrolled.The concentrations of fasting plasma IL-18, PAI-1 and serum fasting insulin(FINS),fasting blood glucose(FBG),plasma blood glucose(PBG) 2 h after meal were detected. Insulin resistance (IR) index was estimated by HOMA.Results The concentrations of plasma IL-18, PAI-1 in IGT group and IFG/IGT group were obviously increased than those in NGT group (P<0.01).The concentrations of plasma IL-18, PAI-1 in IFG/IGT group were obviously increased than those in IGT group(P<0.05 ).The correlation analysis showed that the concentrations of plasma IL-18 and PAI-1 levels were positively correlated with FBG, PBG and HOMA-IR (P<0.01 ).Conclusion The increase of plasma IL-18 and PAI-1 level might be risk factors of HOMA-IR in patients with pre-diabetes. The changes of plasma IL-18 and PAI-1 level in patients with pre-diabetes might be involved in the pathogenesis and development of type 2 diabetes.