| Objective:To study correlation among type 2 diabetes mellitus(T2DM),insulin resistance(IR),IL-6,IL-8,TNF-αand T lymphocyte subsets,and provide theoretical basis for clinical effects and curative effect evaluationMethods:78 patients with T2DM who were treated in Zibo No.1 Hospital from January to July 2017 were selected and divided into FH+DM group(48 patients)and FH-DM group(30 patients)in line with family history.In addition,40 healthy people who conducted physical examination in the same period were chosen and divided into normal FH+control group(10 patients)and FH-control group(30 patients)in accordance with family history.Before treatment,patients in four groups used arginine stimulation test to detect first-phase insulin secretion level and evaluateβ-cell function in each group;patients in FH+DM group and FH-DM group were infused with continuous subcutaneous insulin for intensification therapy to reach the favorable blood glucose control.Patients in FH+DM group and FH-DM group applied arginine stimulation test to detect first-phase insulin secretion level and evaluate changes ofβ-cell function after treatment.The hexokinase method was used to detect influences of continuous subcutaneous insulin infusion on blood glucose control.Enzyme linked immunosorbent assay-double antibody sandwich method(one-step method)was utilized to detect serum interleukin 6(IL-6),interleukin 8(IL-8),and tumor necrosis factor(TNF-α)contents in the normal control group and FH+DM group and FH-DM group before and after treatment.Flow cytometry(FCM)was utilized to detect peripheral blood CD3~+T cells,CD4~+T cells and CD8~+T cells,as well as specific value of CD4~+T cells and CD8~+T cells in each group.Results:(1)Compared with the patients in control group,the glycosylated hemoglobin,blood sugar and HOMA2-IR level of patients in FH+DM and FH-DM groups are higher(P<0.05).The HOMA2-%βof FH+DM group and FH-DM group is obviously higher than that of their control groups(P<0.01).The HOMA2-%βof FH-control group is higher than that of the FH+control group(P<0.05);(2)After reinforced treatment,fasting blood-glucose and postprandial blood sugar in FH+DM group and FH-DM group were significantly reduced.By comparing with pre-treatment,there was the statistical difference(P<0.01);(3)After treatment,pancreaticβcell index in FH+DM group and FH-DM group was improved,while fasting insulin in FH+DM group before treatment was 7.3±2.5mlU/L and after treatment was 15.3±2.5mIU/L.Fasting insulin in FH-DM group before treatment was 7.3±2.0mIU/Land after treatment was 17.0±2.3mIU/L.There was the statistical difference(P<0.01);(4)After treatment,HOMA2-IR in FH+DM group and FH-DM group was less than the value before treatment.Moreover,the improvement situation in FH-DM group was significantly better than FH+DM group.4.7±1.1 vs.3.5±0.6 in FH+DM group;4.7±0.9 vs.3.0±0.5 in FH-DM group,there was the statistical difference(P<0.05);(5)After the treatment,the HOMA2-%βlevel in FH+DM group and FH-DM group is improved(For FH+DM:after treatment the data is76.6±17.7 and before treatment data is 16.2±0.6;FH-DM:after treatment the data is75.3±15.6 and before treatment the data is 15.9±0.5).These differences have the statistics meaning(P<0.01);(6)The serum TNF-αlevel of FH+DM group and FH-DM group are obviously higher than that of their control groups and the differences have the statistics meaning(P<0.01).In addition,their IL-6 and IL-8 level is separately higher than their control groups and the differences have the statistics meaning(P<0.05).After the treatment,the three kinds of cell factors of FH+DM group and FH-DM group are obviously decreased and these comparative differences have the statistics meaning(P<0.05).However,when comparing the three cell factors between FH+control group and FH-control group,between FH+DM group and FH-DM group,between the FH+DM group and FH-DM group after treatment,the differences do not have the statistics meaning(P>0.05).(7)CD3~+T cells,CD4~+T cells and CD8~+T cells,as well as specific value of CD4~+T cells and CD8~+T cells in FH+DM group and FH-DM group were obviously reduced,while CD8~+T cells were obviously increased.There was the statistical difference in the normal control groups(P<0.05).However,by making a comparison on FH+control group and FH-control group,and a comparison between FH+DM group and FH-DM group,there was no statistical difference in the above-mentioned indexes(P>0.05).Conclusion:(1)Reinforced treatment of continuous subcutaneous insulin infusion is the effective means to improve insulinβindexes and HOMA2-IR of patients with T2DM.(2)The expression level of serum IL-6、IL-8、TNF-αis closely related with the insulin resistance in patients with type 2 diabetes but is not related with the family medical history.(3)Patients with T2DM has the disorder in T cell subsets and specific value of CD4~+T cells/CD8~+T cells. |
PDF Full Text Request