·胰岛素抵抗及其相关疾病·

　　【摘要】 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2 hPG将381例中老年糖尿病患者分为IFG 1、IFG2 、IGT、T2DM、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，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 IFG1组与IFG2组HOMA-IR均高于NGT组，HOMA-β均低于NGT组，但两组间HOMA-IR及HOMA-β比较差异无统计学意义;两组HbA1c均高于NGT组，且IFG2组高于IFG1组;两组IFN-γ和IL-4均高于NGT组，两组间IFN-γ差异有统计学意义，但IL-4差异无统计学意义。

　　【关键词】 空腹血糖受损; 胰岛素;干扰素γ(IFN-γ)，血浆;白介素-4(IL-4)

Changes of insulin secretion and sensitivity, levels of IFN- gamma and interleukin -4 in middle-aged and elderly diabetic patients with different levels of impaired fasting glucose CHEN Qi，NIU Jin，ZHU Hui-ming，ZHENG Bei-jia ,ZHONG Qian-yi， XU Qiu-meng， Department of Laboratory ，Taizhou Central Hospital of Zhejiang Province ，Taizhou 318000，China

Corresponding author: ZHONG Qian-yi, E-mail：zhongqy@tzhospital.com

　　【Abstract】 Objective To investigate the role of T helper cell type 1 and 2 (Th1/Th2) immune imbalance in elderly diabetic patients with different levels of impaired fasting glucose(IFG) and the relationship with insulin resistance(IR). Methods A cohort of 381 diabetic patients, older than 55 years of age, was divided into five groups：the normal group，IFG1 group(5.6～7.0 mmol/L)， IFG2 group(6.1～6.1 mmol/L)， IGT group and T2DM group according to the levels of fasting plasma glucose (FPG) and 2 h postprandial plasma glucose(2 hPG). The serum cytokines of interferon-γ(IFN-γ) and interleukin -4(IL-4)were measured by enzyme-linked immunosorbent assay(ELISA). Insulin (Ins) and HbA1c were measured. Results The levels of HOMA-IR in IFG1, IFG2, IGT groups were significantly higher than those in normal group (P<0.05). But no significant difference was observed among IFG1, IFG2 and IGT groups (P>0.05). The levels of HOMA-IR were significantly higher in T2DM group than in the other four groups (P<0.05). The level of HOMA-β in the normal group was significant higher than that in the other four groups(P<0.05). The IGT group had minimal function damage in HOMA-β. Compared with IFG1 group，IFG2 group had higher IFN-γlevel(P<0.05)，and there was no significant difference in IL-4 between two groups(P>0.05). Conclusion IFG1 and IFG2 groups show that:(1)HOMA-IR is significant higher in the two groups than in NGT group. The HOMA-β is significantly lower in two groups than in NGT group. But the differences in HOMA-I R and HOMA-β between the two groups are not statistically significant. HbA1c is higher in the two groups than in NGT group, and HOMA-IR and HOMA-β in IFG2 group are significantly higher than in IFG1 group. (2)IFN-γ and IL-4 levels are higher in two groups than in NGT group. There is a statistical difference in IFN-γ between two groups, but there is no statistically difference in IL–4.

　　【Key words】 Impaired fasting glucose;Insulin; Interferon-γ(IFN-γ);Interleukin -4(IL-4)