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目的探讨辅助性T细胞1型/2型(Th1/Th2)免疫失衡在中老年IFG发病中的作用及与IR的关系。方法根据FPG及2hPG将381例中老年糖尿病患者分为IFG1、IFG2、IGT、T2DM、糖耐量正常(NGT)组。ELISA检测血浆干扰素γ(IFN-γ)、白介素-4(IL-4),同时检测胰岛素及HbA1c水平。结果 IFG1、IFG2、IGT组与NGT组比较,胰岛素抵抗指数(HOMA-IR)均增加(P<0.05),但3组间差异无统计学意义(P>0.05)。T2DM组与其他组比较,HOMA-IR差异有统计学意义(P<0.05),IFG1、IFG2、IGT、T2DM组胰岛β细胞功能指数(HOMA-β)与NGT组比较均降低(P<0.05),IFG2组与IFG1组比较,IFN-γ升高(P<0.05),IL-4变化差异无统计学意义(P>0.05)。结论中老年IFG人群存在IFN-γ和IL-4升高,HOMA-IR与HOMA-β下降。
Objective To investigate the role of Th1 / Th2 immune imbalance in the pathogenesis of IFG in middle-aged and elderly patients and its relationship with IR. Methods According to FPG and 2hPG, 381 middle-aged and elderly diabetic patients were divided into IFG1, IFG2, IGT, T2DM and normal glucose tolerance group (NGT). The levels of IFN-γ, IL-4 and insulin and HbA1c were detected by ELISA. Results Compared with NGT group, the insulin resistance index (HOMA-IR) of IFG1, IFG2 and IGT groups increased (P <0.05), but there was no significant difference among the three groups (P> 0.05). The difference of HOMA-IR between T2DM group and other groups was statistically significant (P <0.05). The function of islet β-cell function index (HOMA-β) in IFG1, IFG2, IGT and T2DM groups was lower than that in NGT group (P <0.05). The difference of IL-4 between IFG2 group and IFG1 group was not statistically significant (P> 0.05). Conclusions There is an increase in the levels of IFN-γ and IL-4 in middle-aged and elderly people with IFG, and the decrease of HOMA-IR and HOMA-β.