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目的观察初诊2型糖尿病(T2DM)患者体内炎症状态及短期持续皮下胰岛素输注(CSII)治疗对T2DM患者体内炎症因子水平的影响。方法60例初诊T2DM患者接受为期2周的CSII强化治疗,于治疗前、后测定血清炎症因子白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)和C反应蛋白(CRP)浓度,同时测定T2DM患者空腹胰岛素水平,采用稳态模型计算胰岛素抵抗指数(HOMA-IR),并选择基线资料匹配的50例体检健康者作为对照组。结果(1)与对照组比较,T2DM患者炎症因子IL-6(P<0.01)、TNF-α(P<0.05)、CRP(P<0.05)显著增高。(2)炎症因子IL-6、TNF-α、CRP与HOMA-IR呈正相关(r1=0.6071,P<0.05;r2=0.8033,P<0.01;r3=0.7435,P<0.01)。(3)CSII治疗2周后炎症因子IL-6、TNF-α、CRP明显降低(P均<0.05),HOMA-IR明显降低(P<0.01)。结论新诊断的T2DM患者处于慢性炎症状态,这种炎症状态与胰岛素抵抗形成有关,短期CSII治疗除降低血糖外,能显著降低T2DM患者的炎症因子水平,改善炎症,减轻胰岛素抵抗。
Objective To investigate the effect of short-term sustained subcutaneous insulin infusion (CSII) on the inflammatory status in newly diagnosed type 2 diabetes mellitus (T2DM) patients and the level of inflammatory cytokines in T2DM patients. Methods Sixty patients with newly diagnosed T2DM received intensive CSII for 2 weeks. Serum levels of IL-6, TNF-α and C-reactive protein (TNF-α) were measured before and after treatment. (CRP). Fasting insulin levels in T2DM patients were also measured. HOMA-IR was calculated using a steady-state model. Fifty healthy people were selected as control group. Results (1) Compared with the control group, the inflammatory factors IL-6 (P <0.01), TNF-α (P <0.05) and CRP (P <0.05) were significantly increased in T2DM patients. (2) There was a positive correlation between inflammatory cytokines IL-6, TNF-α, CRP and HOMA-IR (r1 = 0.6071, P <0.05; r2 = 0.8033, P <0.01; r3 = 0.7435, P <0.01). (3) The levels of IL-6, TNF-α and CRP in CSII decreased significantly (P <0.05) and HOMA-IR decreased significantly (P <0.01). Conclusion The newly diagnosed T2DM patients are in a chronic inflammatory state. The inflammatory state is related to the formation of insulin resistance. Short-term CSII treatment can significantly reduce the level of inflammatory cytokines, improve inflammation and reduce insulin resistance in addition to lowering blood glucose.