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目的:探讨1型糖尿病儿童血巨噬细胞移动抑制因子(macrophage migration inhibitory factor,MIF)和单核细胞趋化蛋白-1(monocyte chemoattractantprotein-1,MCP-1)以及白介素-18(interleukin-18,IL-18)水平及临床意义。方法:对2011年11月~2013年4月在本院就诊的54例1型糖尿病患儿进行MIF、MCP-1、IL-18、糖化血红蛋白(HbA1c)、血pH值检测,根据患儿有无酮症酸中毒分为DKA组和非DKA组,另选25例正常体检健康儿童作为对照组。分析比较疾病不同严重程度、不同病程患儿血中MIF、MCP-1、IL-18水平的差异,同时寻找血pH值、HbA1c与相关细胞因子间的关系。结果:①与健康对照组比较,MIF、MCP-1、IL-18水平在1型糖尿病患儿中显著升高(P<0.01),而IL-18在DKA组中的水平高于非DKA组,差异有统计学意义(P<0.05);②病程小于1年患儿MIF、MCP-1、IL-18水平高于病程大于1年患儿,差异有统计学意义(P<0.01,P<0.05);③直线相关分析显示MCP-1与pH、HbA1c正相关(P<0.05),lg(MIF)与pH、HbA1c无相关性(P>0.05)。结论:MIF、MCP-1、IL-18在1型糖尿病患儿中的水平较正常儿童高,新发病者尤其明显,该类细胞因子参与了儿童1型糖尿病的发生和发展,MCP-1可联合糖化血红蛋白评价患儿近期血糖水平。
Objective: To investigate the expression of macrophage migration inhibitory factor (MIF) and monocyte chemoattractant protein-1 (MCP-1) and interleukin-18 IL-18) levels and clinical significance. Methods: MIF, MCP-1, IL-18, HbA1c and blood pH were measured in 54 patients with type 1 diabetes from November 2011 to April 2013 in our hospital. No ketoacidosis divided into DKA group and non-DKA group, another 25 normal healthy children as the control group. The differences of blood levels of MIF, MCP-1 and IL-18 in children with different severity and different stages of disease were analyzed. The relationship between blood pH, HbA1c and related cytokines was also investigated. Results: ① Compared with healthy control group, the levels of MIF, MCP-1 and IL-18 were significantly increased in children with type 1 diabetes (P <0.01), while the levels of IL-18 in DKA group were higher than those in non-DKA group (P <0.05). ② The levels of MIF, MCP-1 and IL-18 in children with disease less than 1 year were higher than those in children with disease more than 1 year (P <0.01, P < 0.05). ③The linear correlation analysis showed that MCP-1 was positively correlated with pH and HbA1c (P <0.05), but no correlation between Lg (MIF) and pH and HbA1c (P> 0.05). CONCLUSIONS: The levels of MIF, MCP-1 and IL-18 in children with type 1 diabetes are higher than those in normal children, especially in newly diagnosed patients. These cytokines are involved in the development and progression of type 1 diabetes in children. MCP-1 Combined glycated hemoglobin in children with recent blood glucose levels.