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目的 探讨 2型糖尿病患者肿瘤坏死因子α(TNF -α)水平与胰岛素抵抗之间的关系。方法 测定了 2型糖尿病组 10 1例 ,糖耐量异常组 2 7例和正常对照组 18例血清TNF -α水平 ,用稳态模式 (HomaModel)公式评估胰岛素抵抗。结果 2型糖尿病组和糖耐量异常组的胆固醇 (TC)、甘油三酯 (TG)、空腹和餐后 2h胰岛素、体内脂肪含量 (BF)、TNF -α和Homa。IR水平高于正常对照组 (P <0 .0 5 ) ,高密度脂蛋白胆固醇水平 (HDL -C)低于正常对照组 (P <0 .0 5 )。多元逐步回归分析显示 :空腹血糖 (FBG)、体重指数(BMI)、TNF -α、TG是影响 2型糖尿病病人胰岛素抵抗的主要危险因素 (Beta分别为 0 .4 5 1、0 .2 4 5、0 .2 18、0 .16 2 ,P值分别为 0 .0 0 0、0 .0 0 10 .0 0 3、0 .0 30 )。TNF -α水平与舒张压 (DBP)、空腹血糖 (FBG)、餐后 2h血糖 (BG 2h)、空腹胰岛索 (FINS)、低密度脂蛋白胆固醇 (LDL -C)、TC、Homa。IR、BF显著正相关 (r分别为0 .2 18、0 .374、0 .317、0 .2 93、0 .2 18、0 .2 15、0 .4 2 2、0 .2 0 0 ) ,与BMI、WHR不相关。结论 2型糖尿病患者TNF-α水平明显升高 ,并可能加剧了糖尿病患者胰岛素抵抗
Objective To investigate the relationship between the level of TNF-α and insulin resistance in type 2 diabetic patients. Methods Serum levels of TNF-α were measured in 10 1 type 2 diabetes mellitus, 27 normal glucose tolerance group and 18 normal controls. The insulin resistance was evaluated by the Homa model. Results Cholesterol (TC), triglyceride (TG), fasting and 2h postprandial insulin, body fat content (BF), TNF-α and Homa in type 2 diabetic patients and impaired glucose tolerance group. IR level was higher than the normal control group (P <0.05), HDL-C was lower than the normal control group (P <0.05). Multivariate stepwise regression analysis showed that fasting blood glucose (FBG), body mass index (BMI), TNF-α, and TG were the major risk factors for insulin resistance in patients with type 2 diabetes (Beta = 0.55-2.55 , 0 .2 18,0 .16 2, the P values were respectively 0.0000, 0.010, 0.030, 0.030). TNF-α and DBP, FBG, BG 2h, FINS, TC, Homa. IR and BF were significantly correlated (r = 0.218,0.374,0.317,0.293,0.218,0 .2 15,0 .4 2 2,0 .20) , Not related to BMI and WHR. Conclusion The level of TNF-α in patients with type 2 diabetes mellitus is obviously increased, which may aggravate the insulin resistance in diabetic patients