文章摘要

初诊2型糖尿病患者TLR4水平与糖脂代谢及慢性炎症的相关性

作者: 1连 明珠, 1陈 琰, 1彭 静静, 1赵 淑杰
1 吉林大学第二医院内分泌科,长春 130000
通讯: 赵 淑杰 Email: zsjdr@sina.com
DOI: 10.3978/j.issn.2095-6959.2020.04.013
基金: 吉林自然科学基金(3D5195794429)。

摘要

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

Authors: 1LIAN Mingzhu, 1CHEN Yan, 1PENG Jingjing, 1ZHAO Shujie
1 Department of Endocrinology, Second Hospital of Jilin University, Changchun 130000, China

CorrespondingAuthor:ZHAO Shujie Email: zsjdr@sina.com

Foundation: This work was supported by Jilin Natural Science Foundation, China (3D5195794429).

Abstract

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