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目的探讨成人隐匿性自身免疫糖尿病(LADA)患者IFN-γ、IL-4、IL-10水平变化及其与胰岛β细胞功能的关系。方法 ELISA法检测20例1型糖尿病患者、20例LADA患者、20例2型糖尿病患者、20例正常对照外周血血清中IFN-γ、IL-4、IL-10水平,放免法测定C-肽和胰岛素的空腹及餐后2h水平,评价胰岛β细胞功能。结果与对照组相比,3组IFN-γ、IL-4、IL-10水平均有显著升高。IFN-γ测定结果显示LADA组低于T1DM组,高于T2DM组;IL-4和IL-10测定结果显示LADA组低于T2DM组,高于T1DM组。T1DM组和LADA组空腹及餐后2hC-肽和胰岛素显著降低,T2DM组和对照组空腹C-肽和胰岛素无显著差异,餐后2hC-肽和胰岛素均显著增高。结论 LADA患者细胞因子水平紊乱,导致细胞免疫功能失衡,可能是其胰岛β细胞功能损害的因素之一。
Objective To investigate the changes of IFN-γ, IL-4 and IL-10 in patients with latent autoimmune diabetes (LADA) and its relationship with the function of islet β cells. Methods The levels of IFN-γ, IL-4 and IL-10 in peripheral blood of 20 patients with type 1 diabetes, 20 patients with LADA, 20 patients with type 2 diabetes mellitus and 20 normal controls were detected by ELISA. The levels of C-peptide And insulin fasting and postprandial 2h levels, evaluation of pancreatic β-cell function. Results Compared with the control group, the levels of IFN-γ, IL-4 and IL-10 in three groups were significantly increased. The level of IFN-γ in LADA group was lower than that of T1DM group and higher than that in T2DM group. The levels of IL-4 and IL-10 in LADA group were lower than those in T2DM group and higher than those in T1DM group. Fasting and postprandial 2-hour C-peptide and insulin were significantly decreased in T1DM and LADA groups, but there was no significant difference between fasting C-peptide and insulin in T2DM group and in control group, while both C-peptide and insulin in post-prandial group were significantly increased. Conclusions The levels of cytokines in patients with LADA disorder, leading to imbalance of cellular immune function may be one of the factors of pancreatic β-cell dysfunction.