老年2型糖尿病患者白细胞介素与尿微量白蛋白/肌酐比值的相关性

目的：探讨老年2型糖尿病（T2DM）患者血清中不同类型白细胞介素水平变化,及其与尿微量白蛋白/肌酐比值（ACR）间的关系。方法：117例老年T2DM患者根据尿微量白蛋白排泄率（UAER）分为无蛋白尿组（n=29）、微量蛋白尿组（n=48）和大量蛋白尿组（n=40）。30例体检健康老人作为对照组。酶联免疫吸附试验测定受试者血清中白细胞介素-2（IL-2）、白细胞介素-6（IL-6）、白细胞介素-8（IL-8）、白细胞介素-10（IL-10）、白细胞介素-18（IL-18）水平。同时测定ACR。对各组白细胞介素水平差异及与ACR相关性进行统计学分析。结果：与对照组比较,各组T2DM患者血清IL-2、IL-6、IL-8、IL-18显著升高,IL-10显著降低（P〈0.05）;大量蛋白尿组和微量蛋白尿组IL-2、IL-6、IL-8、IL-18水平高于无蛋白尿组;大量蛋白尿组IL-2、IL-6、IL-8、IL-18水平高于微量蛋白尿组,各组差异具有统计学意义（P〈0.05）;T2DM患者血清IL-6、IL-8与ACR呈正相关（r=0.35,P〈0.01;r=0.42,P〈0.01）。结论：IL-6、IL-8可能参与糖尿病肾病的发生发展,是早期诊断糖尿病肾损害的敏感指标之一。

Relationship between interleukins and microalbuminuria /creatinine ratio in elderly patients with type 2 diabetes mellitus

Objective： To explore the interleukins level and its relationship with microalbuminuria/creatinine ratio（ACR） in elderly type 2 diabetes mellitus（T2DM）.Methods： A total of 117 elderly patients with T2DM and 30 healthy controls participated in this study.Subjects with T2DM were divided into three groups using urinary albumin-to-creatinine ratio（ACR） ： a normoalbuminuric group（group NA,n = 29,UAER 30 mg /24 h）,a microalbuminuria group（group MA,n = 48,UAER 30-300 mg /24 h） and a macroalbuminuria group（group ODN,n = 40,UAER 300 mg /24 h）.The serum interleukin-2（IL-2） 、 IL-6、IL-8、IL-10、IL-18 concentrations were determined by enzyme linked immunosorbent assay（ELISA）,albuminuria / creatinine ratio（ACR） was detected by DCA2000.Results： Compared with the control group,the groups of T2DM had higher serum IL-2、IL-6 、IL-8 、IL-18 levels and lower serum IL-10 concentration（P 0.05 respectively）.Group ODN had higher serum concentrations of IL-2、IL-6、IL-8、IL-18 compared with group MA and group NA（P 0.05 respectively）.The serum IL-6、IL-8 levels were positively correlated with ACR level in T2DM patients with DN（r = 0.35,P 0.01;r = 0.42,P 0.01）.Conclusion： IL-6、IL-8 maybe facilitate the development of diabetic nephropathy,and they may be the sensitive indicators to diagnose early stage clinical diabetic nephropathy.