1 吉林大学第二医院内分泌科，长春 130000
目的：探讨初诊2型糖尿病患者血清Toll样受体4(Toll-like receptor 4，TLR4)水平变化及其与糖脂代谢和慢性炎症的相关性。方法：选取2018年9月至2019年1月于吉林大学第二医院内分泌科就诊的150例初诊2型糖尿病患者及45例正常体检人员，将所选研究对象分为正常对照组(NC组，n=45)，2型糖尿病组(T2DM组，n=85)，2型糖尿病合并超重或肥胖组(T2DM+OB组，n=65)。统计并检测各组年龄，性别，病程，BMI，三酰甘油(triglyceride，TG)，总胆固醇(total cholesterol，TC)，高密度脂蛋白胆固醇(high density lipoprotein cholesterol，HDL-C)，低密度脂蛋白胆固醇(low density lipoprotein cholesterol，LDL-C)，空腹血糖(fasting plasma glucose，FPG)，糖化血红蛋白(glycosylated hemoglobin，HbA1c)，空腹胰岛素(fasting insulin，FINS)，稳态胰岛素评价指数(homeostasis modeall assessment of insulin resistance，HOMA-IR)，超敏C反应蛋白(high-sensitivity C-reactive protein，hs-CRP)。ELISA检测血清TLR4水平。3组间比较采用方差分析；应用Pearson相关分析血清TLR4与BMI，TG，LDL-C，HOMA-IR，hs-CRP的相关性；logistic回归分析2型糖尿病合并超重或肥胖的独立危险因素等。结果：NC组、T2DM组、T2DM+OB组的TG，LDL-C，FPG，HbA1c，FINS，HOMA-IR，hs-CRP，TLR4水平逐渐升高，3组间差异有统计学意义(P<0.05)。相关性分析显示：血清TLR4水平与BMI，TG，LDL-C，HOMA-IR及hs-CRP呈正相关。Logistic回归分析显示：LDL-C，HOMA-IR，hs-CRP，TLR4是2型糖尿病合并肥胖或超重的独立危险因素。结论：初诊2型糖尿病患者血清TLR4水平升高，其合并超重或肥胖的风险越大。关键词： 初诊2型糖尿病；超重或肥胖；Toll样受体4；慢性炎症
Correlation between serum Toll-like receptor 4 and glucose and lipid metabolism and chronic inflammation in newly diagnosed type 2 diabetic patients
CorrespondingAuthor:ZHAO Shujie Email: firstname.lastname@example.org
Foundation: This work was supported by Jilin Natural Science Foundation, China (3D5195794429).
Objective: To explore the relationship between the serum levels of Toll-like receptor 4 (TLR4) and glucose and lipid metabolism and chronic inflammation in patients with newly diagnosed type 2 diabetes mellitus. Methods: A total of 150 newly diagnosed type 2 diabetic patients and 45 normal controls in Department of Endocrinology of Second Hospital of Jilin University from September 2018 to January 2019 were enrolled. They were divided into three groups: a normal control group (NC group, n=45), a type 2 diabetes group (T2DM group, n=85), and a type 2 diabetes with overweight or obesity group (T2DM + OB group, n=65). Data including age, gender, disease duration, BMI, triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1c), fasting insulin (FINS), homeostasis modeall assessment of insulin resistance (HOMA-IR), and high-sensitivity C-reactive protein (hs-CRP) were determined. The serum levels of TLR4 were determined by ELISA. The comparison between groups was tested by analysis of variance; correlation between serum TLR4 and BMI, TG, LDL-C, HOMA-IR and hs-CRP was performed by Pearson correlation analysis; logistic regression was used to analyze the independent risk factors of type 2 diabetes with overweight or obesity. Results: TG, LDL-C, FPG, HbA1c, FINS, HOMA-IR, hs-CRP and TLR4 in the NC group, the T2DM group and the T2DM+OB group gradually increased, and the difference among the 3 groups was statistically significant (P<0.05). There was a positive correlation between TLR4 with BMI, TG, LDL-C, HOMA-IR, and hs-CRP. Logistic stepwise analysis showed that LDL-C, HOMA-IR, hs-CRP and TLR4 were independent risk factors of type 2 diabetes with overweight or obesity. Conclusion: The higher the level of TLR4 in patients with newly diagnosed type 2 diabetes, the greater the risk of overweight or obesity.Keywords： newly diagnosed type 2 diabetes mellitus; overweight or obesity; Toll-like receptor 4; chronic inflammation