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目的探讨血清肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)、热休克蛋白70(heat shock protein 70,HSP70)表达水平对宁夏回、汉民族2型糖尿病(type 2 diabetes mellitus,T2DM)发病的影响。方法采用病例对照研究设计,按照纳入与排除标准,于2011年10月至2012年10月在宁夏医科大学第二附属医院与教学医院(吴忠市人民医院)内分泌科确诊的225例T2DM患者及同期健康检查人群中确定的600例健康人作为研究对象。采用双抗体夹心酶联免疫吸附法(enzyme linked immunosorbent assay,ELISA)测定血清中TNF-α与HSP70蛋白表达水平。结果病例组回、汉族合计人群和回族人群血清TNF-α表达水平明显高于对照组(t=-3.512,-3.791,均P<0.01);病例组汉族人群TNF-α表达水平及回、汉民族中不同组间HSP70表达水平的差异均无统计学意义(t=-0.565,-0.020,-1.251,-0.809,均P>0.05);TNF-α水平高表达人群的发病风险明显高于低表达人群(OR=1.500,95%CI:1.075~2.093,P=0.017)。回族合计人群、回族病例及回族对照人群血清TNF-α表达水平均显著低于汉族合计人群、汉族病例及汉族对照人群,差异均有统计学意义(t=9.373,2.223,9.734,均P<0.01或0.05)。TNF-α表达水平与血糖水平呈正相关(r=0.110,P=0.001),HSP70表达水平与血糖水平间无明显相关关系(r=0.023,P=0.504)。多因素Logistic回归分析显示,性别和腰臀比(waist-to-hip ratio,WHR)为TNF-α高表达的危险因素(P<0.01或0.05),HSP70和民族为保护因素;收缩压(systolic blood pressure,SBP)和WHR为HSP70高表达的危险因素(均P<0.01),TNF-α为保护因素(P<0.05);HSP70、TNF-α、性别、家族史、BMI、SBP、甘油三酯(triglycerides,TG)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)、丙氨酸氨基转移酶(alanine trans-aminase,ALT)、心理应激为T2DM发病的危险因素(P<0.01或0.05),高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)为保护因素。结论血清TNF-α表达水平增高与血糖水平的升高及T2DM的发病密切相关,高表达患者T2DM的风险明显增加;回族人群血清TNF-α表达水平明显低于汉族人群,可能与民族遗传有关;血清HSP70表达水平可能与T2DM的发病有关。
Objective To investigate the effect of serum tumor necrosis factor-α (TNF-α) and heat shock protein 70 (HSP70) on the expression of type 2 diabetes mellitus (T2DM) The impact of the disease. Methods A case-control study was designed. According to inclusion and exclusion criteria, 225 patients with T2DM diagnosed in Department of Endocrinology, Second Affiliated Hospital and Teaching Hospital of Ningxia Medical University (Wuzhong People’s Hospital) from October 2011 to October 2012, 600 healthy subjects identified in the health checkup population were selected as study subjects. The levels of TNF-α and HSP70 in serum were measured by enzyme-linked immunosorbent assay (ELISA). Results The serum level of TNF-α in the Han and Hui groups was significantly higher than that in the control group (t = -3.512 and -3.791, both P <0.01) There was no significant difference in the expression level of HSP70 among different groups (t = -0.565, -0.020, -1.251, -0.809, all P> 0.05). The risk of developing high TNF-α was significantly higher than that of low The population was expressed (OR = 1.500, 95% CI: 1.075 to 2.093, P = 0.017). The serum levels of TNF-α in Hui population, Hui population and Hui population were significantly lower than those in Han population, Han population and Han population (t = 9.373,2.223,9.734, all P <0.01 Or 0.05). There was a positive correlation between the expression of TNF-α and blood glucose (r = 0.110, P = 0.001). There was no significant correlation between the expression level of HSP70 and blood glucose level (r = 0.023, P = 0.504). Multivariate Logistic regression analysis showed that gender and waist-to-hip ratio (WHR) were the risk factors for the high expression of TNF-α (P0.01 or 0.05), HSP70 and ethnic groups were protective factors, systolic blood pressure (SBP) and WHR were the risk factors of HSP70 overexpression (all P <0.01), while TNF-α was the protective factor (P <0.05). HSP70, TNF-α, sex, family history, BMI, SBP, Triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), alanine trans-aminase (ALT) and psychological stress were the risk factors of T2DM <0.01 or 0.05), high-density lipoprotein cholesterol (HDL-C) as a protective factor. Conclusions The increased serum TNF-α level is closely related to the increase of blood glucose level and the incidence of T2DM. The risk of T2DM in patients with high expression is significantly increased. The serum level of TNF-α in Hui population is significantly lower than that in Han population, which may be related to national genetics. Serum HSP70 expression may be related to the pathogenesis of T2DM.