阿托伐他汀对2型糖尿病患者外周血单核细胞TLR4表达的影响

目的探讨阿托伐他汀对2型糖尿病的抗炎作用机制是否与抑制toll样受体4（TLR4）有关。方法将40例2型糖尿病患者随机分为常规治疗组和阿托伐他汀治疗组。阿托伐他汀治疗组患者在常规治疗基础上给予阿托伐他汀20 mg,1次/d,晚间口服。治疗前及治疗1月后采血,应用流式细胞仪检测外周血单核细胞TLR4蛋白表达;应用酶联免疫（ELISA）法检测血浆肿瘤坏死因子-α（TNF-α）浓度。结果单核细胞TLR4蛋白与血糖,糖化血红蛋白及血浆TNF-α呈正相关。治疗1月后,阿托伐他汀治疗组和常规治疗组血糖、外周血单核细胞TLR4蛋白及血浆TNF-α浓度均较治疗前降低（P〈0.05）;阿托伐他汀治疗组单核细胞TLR4蛋白和血浆TNF-α均低于常规治疗组（P〈0.05）。结论阿托伐他汀能下调2型糖尿病患者的单核细胞TLR4表达,降低血浆炎症因子水平。其抗炎作用可能与抑制单核细胞TLR4通路有关。

Effect of atorvastatin on circulation monocytes TLR4 expression in patients with type 2 diabetes

Objective To investigate whether the anti-inflammatory effect of atorvastatin in type 2 diabetes was correlated with down-regulating toll-like receptor 4（TLR4） expression.Methods 40 type 2 diabetic patients were recruited and randomly divided into routine treatment group and atorvastatin treatment group.Atorvastatin treatment group was given atorvastatin 20 mg every night additionally.Before and after 1 month treatment,the expression of TLR4 protein on monocytes was assayed by flow cytometry,concentration of plasma tumor necrosis factor-α（TNFα） was measured by enzyme-linked immunosorbent assay（ELISA）.Results Monocytes TLR4 expression positively correlated with blood glucose,HbA1c and levels of plasma TNF-α.After 1 month treatment,blood glucose,monocytes TLR4 expression and plasma TNF-α were decreased in two groups（P〈0.05）.Type 2 diabetic patients using atorvastatin had less TLR4 expression and lower plasma TNF-α level than those not using（P〈0.05）.Conclusion Atorvastatin can decrease circulation monocytes TLR4 expression and plasma inflammatory cytokine levels in type 2 diabetes.The anti-inflammatory effect of atorvastatin may be partially mediated by inhibiting TLR4 signaling.