2型糖尿病血清白介素-10与颈动脉内中膜厚度的相关性

目的：研讨不同程度颈动脉粥样硬化的2型糖尿病（type 2 diabetes mellitus,T2DM）患者血清白介素-10（inter-leukin-10,IL-10）的水平的变化及其与颈动脉内膜中层厚度（carotid intima-media thickness,IMT）的相关性。方法：选择沈阳医学院奉天医院内分泌科2008年6月至2009年6月住院T2DM患者共60例,并经彩色多普勒超声检测IMT将其分为三组：IMT正常组（IMT〈1.0 mm）20例、IMT增厚组（1.0 mm≤IMT≤1.2 mm）20例、颈动脉粥样硬化斑块形成组（IMT〉1.2 mm）20例。同时从健康查体者中选取20名志愿者作为正常对照组。受试者均晨起空腹,记录一般资料,包括身高、体重、腰围、收缩压和舒张压,并计算体重指数。口服75 g葡萄糖行葡萄糖耐量试验（oral glucose tolerance test,OGTT）,采空腹静脉血10 ml,测定空腹血糖（FBG）、胰岛素（FINS）、糖化血红蛋白（hemoglobin A1C,HbA1c）、血脂及血清IL-10浓度。数据统计采用SPSS13.0软件完成。结果：T2DM患者的颈动脉IMT均值明显高于正常对照组（P〈0.01）,即使IMT正常的T2DM患者的IMT值亦高于正常对照组（P〈0.05）。T2DM患者的血清IL-10水平明显低于正常对照组（P〈0.01）,在IMT正常的T2DM患者的血清IL-10浓度明显低于正常对照组（P=0.012）,并且在三组不同IMT的T2DM组,IL-10水平差异亦具有显著性（P〈0.05）。相关分析显示,血清IL-10水平与IMT、BMI、WC、FBG、HbA1c、TC、TG、LDL-C及HOMA-IR呈负相关,其中与IMT的相关系数最高（r=-0.74,P〈0.01）。经过Logistic回归分析发现,IL-10水平下降、病程、TG升高、HbA1c水平升高是T2DM患者颈动脉IMT增厚的危险因素。结论：T2DM患者血清IL-10水平明显降低,并且与颈动脉IMT呈明显负相关,提示IL-10降低可能参与了T2DM患者动脉粥样硬化的发生发展,是颈动脉IMT增厚的危险因素之一。

Association of Serum Interleukin-10 with Carotid Intima-media Thickness in Type 2 Diabetes Mellitus

Objective:To study the changes of serum interleukin-10(IL-10) in patients with type 2 diabetes mellitus(T2DM),and explore the relationship between serum IL-10 and carotid intima-media thickness(IMT).Methods:A total of 60 patients with T2DM were selected.These patients were further divided into three groups: 20 patients with normal IMT(IMT<1.0 mm),20 patients with higher IMT(1.0 mm≤IMT≤1.2 mm),20 patients with atherosclerotic plaque(IMT>1.2 mm).20 healthful volunteers from conventional physical people were taken as normal controls.After fasting more than 8 hours overnight,10 ml blood sample were collected from the elbow vein and separated routinely.Serum IL-10 levels were measured by enzyme-linked immunosorbent assay(ELISA),OGTT were taken and fasting blood glucose,insulin,blood lipid and hemoglobin A1c(HbA1c) were detected.Height,body weight,waist circumference(WC) were measured and body mass index(BMI),HOMA-IR were calculated.The data were ananlyzed by ststistical software SPSS 13.0 version.Results:The value of carotid IMT were significantly increased in patients with T2DM compared with normal controls(P<0.01),even in patients with normal IMT(P<0.05).The levels of serum IL-10 in patients with T2DM reduced obviously compared to normal controls(P<0.01),even in patients with normal IMT(P=0.012).A correlation analysis showed that there were remarkable negative correlation between IL-10 and IMT,BMI,WC,FBG,HbA1c,TC,TG,LDL-C,HOMA-IR,more significant with IMT(r=-0.74,P<0.01).With logistic regression analysis,the lower serum IL-10,extension of diabetic course,higher TG and HbA1c were risk factors for the increase IMT.Conclusion:Serum concentrations of IL-10 decreased significantly in patients with T2DM,negatively correlated with the value of carotid IMT.These results indicated that IL-10 may take part in the development of artherosclerosis in patients with T2DM,and lower level of IL-10 is an important risk factor for the increase IMT.