The Relationship Between The Levels Of Serum Inflammatory Cytokines In Type 2 Diabetes Patients With Different Urinary Albumin Excretion Rate And Insulin Resistance

ObjectiveTo study the relationship between the level of serum inflammatory cytokines in Type 2 diabetes patients with different urinary albumin excretion rate(UEAR) and insulin resistance.MethodsOne hundred and thirteen patiesnts with type 2 diabete were selected for this study. The patients were divided into three group according to urinary albumin excretion rate(UEAR)(urinary albumin to creatinine ratio,ACR):43 patients with normal UAER were D1 group,39 patients with microalbuminuria were D2 group,31 patients with clinical albuminuria were D3 group.The level of Serum amyloid-A(SAA), interleukin-6(IL-6), C-reactive protein(CRP), tumor necrosis factor-a (TNF-a) and Body mass inex(BMI),fasting plasma glucose(FPG), fasting insulin(FINS), Glycosylatde hemoglobin AlC(HbAlC) were measured and those of 41 normal control subjects at the same time. Homeostatic model assessment insulin resistant (HOMA-IR) was used to assess of the status of insulin resistance.ResultsCompared with normal control group, levels of inflammatory cytokines SAA,IL-6,CRP and TNF-awere significantly higher(P<0.001, P＜0.001, P＜0.001, P<0.001;respepectively).Compared with normal albuminuria group, levels of inflammatory cytokines in microalbuminuria group and clinical albuminuria group were significantly higher (P＜0.001, P＜0.001; respepectively). Level of inflammatory cytokines in clinical albminuria group were higher than that of microalbuminuria group(P<0.001). Pearson correlation analysis showed that levels of inflammatory cytokines SAA,IL-6,CRP and TNF-a were positively correlated with diabetes duration;respepectively),ACR,FPG,HbAlC and Homa-IR. We also found there was significant associations between Homa-IR and ACR in diabetic patients. Multivariate Regression Analysis showed that levels of inflammatory cytokines SAA were positively correlated with ACR,FPG,BMI and diabetes duration; Level of IL-6 was positively correlated with ACR,HbAlC and BMI; Level of CRP was positively correlated with ACR and HbAlC; Level of TNF-a was positively correlated with ACR,FPG and BMI.ConclusionThese results suggest that serum inflammatory cytokines SAA,IL-6,CRP and TNF-a may be involved in the progression of DN (diabetic nephropathy) and they were closed releated with insulin resistance. Insulin resistance and diabetic nephropathy there are also closely related.