【摘要】  目的    探讨T2DM患者不同血糖控制水平葡萄糖转运蛋白1/4（GLUT1/4）的表达及其对迁移抑制因子（MIF）的影响。 方法   选取T2DM患者84例（研究组）及正常健康成志愿者70名（NC组）。根据HbA₁c水平将研究组再分为低水平亚组(LH) 29例HbA₁c<7.0%；中水平亚组（MH）28例7.0%≤HbA₁c<10.0%；高水平亚组（HH）27例HbA₁c>10.%。ELISA检测各组血浆GLUT1/4、MIF及FPG等相关指标；高效液相色谱法测定HbA₁c水平；RT-PCR测定GLUT1/4、MIF表达情况。多元回归分析GLUT4与MIF、HbA₁c的相关性。 结果   研究组FPG、2 hPG、FIns与对照组比较，差异有统计学意义（P<0.05），ELISA与RT-PCR结果发现，研究组GLUT1与NC组比较，差异无统计学意义（P>0.05）。HH、MH亚组HbA₁c、FIns、HOMA-IR、2 hPG、TNF-a、IL-6、细胞间黏附因子-1（ICAM-1）、MIF及GLUT4均高于LH亚组（P<0.05或P<0.01），HH亚组HbA₁c、2 hPG、TNF-a、IL-6、ICAM-1、高敏C-反应蛋白（hsC-RP）、MIF及GLUT4高于MH亚组（P<0.05或P<0.01）。随着HbA₁c水平的升高，各亚组GLUT4下降（P<0.01）。Logistic回归分析发现，MIF、HbA₁c是GLUT4的独立危险因素。  结论  HbA₁c、MIF在T2DM中呈高表达，其与GLUT1无相关性，而与GLUT4呈负相关。

    【关键词】 糖化血红蛋白；迁移抑制因子；糖尿病，2型；葡萄糖转运蛋白1；葡萄糖转运蛋白4

       Expression of GLUT1/4 in different glucose level and its effect on migration inhibitory factor in patients with type 2 diabetes mellitus 

    [Abstract]  Objective  To investigate the expression of glucose transporter protein 1,4 (GLUT1/4) in different glucose level and its effect on migration inhibitory factor in patients with type 2 diabetes mellitus.  Method  A total of 154 subjects were enrolled in this study and divided into two groups: Patients with type 2 diabetes group (n=84, study group) and normal healthy adult volunteers (n=70, control group). The study group were further divided into three subgroups according to their HbA1c levels: low HbA1c group with HbA₁c <7.0% (n=29, LH subgroup), middle HbA₁c group with 7.0%≤HbA₁c<10.0% (n=28, MH subgroup), and high HbA₁c group with HbA₁c>10.% (n=27, HH subgroup). Plasma GLUT1/4, MIF and FPG level were measured by ELISA. HbA₁c was tested by HPLC. The expression of GLUT1/4 and MIF were analyzed by RT-PCR. Multiple regression analysis was used to evaluate the relationship between GLUT1/4 and MIF, HbA₁c. Results  FPG, 2 hPG and FIns were statis-tically different between study group and control group (P<0.05). ELISA and RT-PCR test results showed that GLUT1 was not different between study group and control group (P>0.05). HbA₁c, FIns, HOMA-IR, 2 hPG, TNF-α, IL-6, ICAM-1 ,MIF and GLUT4 were higher in HH and MH subgroup than in LH subgroup (P <0.05 or P <0.01). HbA₁c, 2 hPG, TNF-α, IL-6, ICAM-1, hsC-RP, MIF and GLUT4 were higher in HH subgroup than in MH subgroup (P <0.05 or P <0.01). GLUT4 decreased when HbA1c level increased (P<0.01). Logistic regression analysis showed that MIF and HbA1c were the independent risk factor for GLUT4.   Conclusion  The high level of HbA₁c and MIF in T2DM patients were not associated with GLUT1, but negatively correlated with GLUT4.

    [Key words]  Glycated hemoglobin A1c; Migration inhibitory factor; type 2 Diabetes; Glucose Transporter 1（GLUT1）; Glucose Transporter 4 （GLUT4）