| Objective:To study the change rules of inflammatory cytokines in type 2 diabetes mellitus(T2DM)patients with stroke,and to provide new ideas for the prevention of acute ischemic stroke in T2DM patients.Methods:From February 1,2018 to October 31,2019,patients from the Department of Endocrinology and Metabolism,Department of Neurology and Department of Neurological Intervention of Qujing Hospital Affiliated to Kunming Medical University were selected.Among them,patients with T2DM were group 1,patients with T2DM combined with acute ischemic stroke were group 2,and patients with acute ischemic stroke were group 3,with 80 patients in each group.All subjects were blooded without eating in the morning.The observation indexes include:(1)basic information of patients,including gender,age,clinical diagnosis,body mass index(BMI);(2)biochemical indicators,including glycated hemoglobin(HbA1c),fasting blood glucose(FPG),serum triglyceride(TG),serum total cholesterol(CHOL),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),erythrocyte sedimentation rate(ESR);(3)inflammatory cytokines,including C-reactive protein(CRP),interleukin 2(IL-2),interleukin 4(IL-4),interleukin 6(IL-6),interferon gamma(IFN-y),tumor necrosis factor alpha(TNF-α).The SPSS25.0 statistical software was used to establish data and conduct statistical analysis.The study was approved by the Hospital Ethics Committee and the Academic Committee,and informed consent was obtained from the patients or family members involved in the study,and the informed consent was signed.Results:(1)The difference in BMI among the three groups was statistically significant(χ2=1 6.855,P=0.000).The level of BMI in group 1 was basically the same as that in group 2,while the level of BMI in group 3 was lower than that in other two groups.(2)The levels of HbAlc,GLU,TG,CHOL,HDL-C,LDL-C,CRP,ESR,IL-2,IL-4,IL-6,IL-10,IFN-y and TNF-α among the three groups were significantly different(P>0.05);Among them,the levels of HbAlc,FPG,TG and LDL-C among the three groups were as follows:group 2>group 1>group 3;the level of CHOL in group 1 was basically the same as that in group 2,while the level of CHOL in group 2 was higher than that in other two groups;the level of HDL-C in group 1 was basically the same as that in group 3,and the level of HDL-C in group 2 was lower than that in the other two groups;the level of CRP in group 2 was basically the same as that in group 3,while the level of CRP in group 1 was lower than that in the other two groups;The levels of ESR among the three groups were as follows:Group 2>Group 3>Group 1.(3)The levels of IL-2,IL-4,IL-6,IL-10,IFN-y,and TNF-α among the three groups were statistically significant(P<0.05).Among them,the levels of IL-2,IL-6 and IL-10 among the three groups were as follows:group 3>group 2>group 1;the levels of IL-4 in group 1 and group 2 were basically the same,and the levels of IL-4 in group 3 were lower than the other two groups;the levels of IFN-y and TNF-α in group 1 and group 2 were basically the same,and the levels of IFN-y and TNF-α in group 3 were higher than the other two groups.(4)BMI,CHOL,HDL-C,IL-6,IL-10,IFN-y,TNF-α were negatively correlated with acute ischemic stroke in T2DM;HbAlc,FPG,TG,LDL-C,CRP,ESR,IL-2,IL-4 were positively correlated with acute ischemic stroke in T2DM.(5)According to the regression analysis,HbAlc,LDL-C and ESR were the risk factors of T2DM combined with acute ischemic stroke(OR=1.506,8.707,1.098);CHOL,HDL-C and TNF-α were the protective factors of T2DM combined with acute ischemic stroke(OR=0.273,0.000,0.427).Conclusion:(1)The increase of level of HbAlc,FPG,TG,LDL-C,CRP and the decrease of level of HDL-C are correlated with the occurrence and development of T2DM combined with acute ischemic stroke;(2)the levels of IL-2,IL-10 and IFN-y in group 3 are higher than those in groups 1 and 2,which may be related to the occurrence and development of acute ischemic stroke;(3)TNF-α is a protective factor for T2DM combined with acute ischemic stroke,which can provide new ideas for the prevention of acute ischemic stroke in T2DM patients;(4)This study suggests that CHOL is a protective factor for T2DM combined with acute ischemic stroke,which is contrary to the currently recognized CHOL as an important risk factor for cardiovascular and cerebrovascular diseases,which may be related to the insufficient sample size in this experiment. |
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