2型糖尿病患者血清单核细胞趋化蛋白1、白细胞介素18与颈动脉内膜中膜厚度相关性研究

目的 探讨2型糖尿病患者血清单核细胞趋化蛋白1(monocyte chemotactic protein-1,MCP-1)、白细胞介素18(IL-18)水平与颈动脉内膜中膜厚度(carotid intima-media thickness,CIMT)的关系.方法 60例2型糖尿病患者分为大血管病变组30例和无大血管病变组30例,体检健康者为对照组30例.超声测定CIMT,酶联免疫吸附法测定血清MCP-1、IL-18水平.结果 2型糖尿病有、无大血管病变组血清MCP-1(无大血管病变组血清MCP-1除外)、IL-18、CIMT明显高于对照组,MCP-1(387.57±75.41)ng/L,(177.48±38.35)ng/L vs(122.51±8.98)ng/L,IL-18(54.76±16.31)ng/L、(35.08±8.83)ng/L vs(26.13±7.05)ng/L,CIMT(1.44±0.33)mm、(1.06±0.26)mm vs(0.68±0.12)mm(均P<0.01);大血管病变组上述指标又高于无大血管病变组(均P<0.01).直线相关分析显示2型糖尿痛患者血清MCP-1与空腹血糖(FPG)、餐后2小时血糖(2 hPG)、糖化血红蛋白、收缩压、低密度脂蛋白胆固醇、CIMT和IL-18呈正相关(P<0.01或<0.05);血清IL-18与FPG、2 hPG、甘油三酯、CIMT、MCP-1呈正相关(P<0.01或<0.05).多元线性回归分析显示年龄、MCP-1、IL-18是ClMT升高的危险因素(t=2.694、6.466、2.445,均P<0.01).结论 2型糖尿病患者血清MCP-1、IL-18与CIMT密切相关,提示两者可能是亚临床期动脉粥样硬化的危险因素.

Correlation between levels of serum MCP-1, IL-18 and carotid intima-media thickness in patients with type 2 diabetes

Objective To investigate the association of serum monocyte chemotactic protein-1 （MCP-1）, interlenkin-18（IL-18） and the carotid intima-media thickness（CIMT） in patients with type 2 diabetes. Methods 90 serum specimens were collected from 60 patients with type 2 diabetes and 30 matched healthy subjects. The patients of type 2 diabetes were divided into two groups： macrovascular complication group（MVC, n = 30） and non-macrovaseular complication group（non-MVC, n = 30）. The levels of serum MCP-1 and IL-18 were detected by enzyme-linked immunosorbent assay. The IMT was examined by hypersensitive color Doppler ultrasonography. Results The level of serum MCP 1 was significantly higher in type 2 diabetes patients with MVC group, non-MVC group than in agematched eontroll group,MCP-1 level （387.57~75.41） ng/L, （177.48~38.35） ng/L vs （122.51~8.98） ng/L. The serum IL-18 and CIMT were significantly higher in the former two groups than those in age-matched controlled group, IL-18 （54.76~16.31） ng/L,（35.08~8.83） ng/L vs （26.13~7.05） ng/L,CIMT （1.44~0.33） mm,（1.06~0.26） mm vs （0.68~0.12） mm（all P 〈0.01）. The above indexes in MVC group were higher than those in non-MVC group. Spearman correlation analysis showed that MCP 1 was positive correlated with fasting plasma glucose（FPG）,2-hour postprandial plasma glucose （2 hPG）, glycohemoglobin, systolic blood pressure, low density lipoprotein cholesterol, CIMT and IL-18 in type 2 diabetes patients group and IL-18 positive correlated with FPG,2 hPG, triglyceride,CIMT, MCP-1. Linear regression analysis showed that the serum MCP-1 and IL-18 levels were risk factors for elevated CIMT. Conclusion The study suggests that there is a strong correlation between MCP-1,IL-18 and CIMT. MCP-1, IL-18 might be important independent risk factors for subclinical macrovascular complications.