The Changes And Their Significance Of Serum Tumor Necrosis Factor-α And Free Fatty Acids In Different Glycometabolic States

Objective: to observe the changes of serum tumor necrosis factor alpha (TNFa) and free fatty acids ( FFA ) in different glycometabolic states so as to determine their role in the development and progression of diabetes. Methods: Oral glucose tolerance test (OGTT) and insulin release test were carried out in 86 individuals with normal glucose tolerance ( NGT), 75 individuals with impaired glucose tolerance ( IGT) and 58 individuals with diabetes (DM). All the subjects with IGT and DM were newly diagnosed and accepted no drug treatment. 27 subjects with NGT, 28 subjects with IGT and 21 subjects with DM were selected and further determination was performed among them, such as serum fasting TNFa and FFA , and 2h post prandial FFA. Homa insulin resistance index ( Homa-IR ) and Homa β cell function index ( HBCI ) were caculated. In the same time we studied 19 patients with diabetic ketoacidosis ( DKA ) , some parameters were measured on admission ( before insulin therapy ) and after insulin therapy and resolution of ketoacidosis, including blood glucose, carbon dioxide combining power ( CO₂CP ) , blood ketone bodies, urine ketone bodies, glycosylated hemoglobin , serum TNFa and FFA concentrations. Rerults: Serum levels of TNFa and FFA were increased in T2DM and IGT compared with NGT subjects (p < 0.01) ; the serum levels of fasting FFA were markly increased compared with FFA levels of 2h after OGTT in NGT, IGT and T2DM groups (p < 0.01); the serum levels of both fasting FFA and 2h FFA after OGTT were markly increased in IGT and T2DM compared with NGT (p < 0.05) . Circulating levels of TNFa and FFA were significantly elevated in patients with DKA on admission, and they markly decreased after insulin therapy, (p...