Study On The Inter-relationship Between The Level Of Serum TNF-α And The Type 2 Diabetes Mellitus With Metabolic Syndrome

Objective To investigate the role played by serum tumor necrosis factor-α(TNF-α) in the pathogenesis of type 2 diabetes mellitus with metabolic syndrome. Methods 257 patients came from Xuan Wu Hospital Endocrinology department from May, 2004 to November, 2006, and have been diagnosed as T2DM over half a year, they have not acute or chronic infections ,they are not diagnosed as other endocrinic diseases. According to the 2005 IDF MS definition, the patients are grouped into group MS (T2DM with MS n=174) and group NMS (T2DM without MS n=83), control group are 43 healthy subjects. The serum levels of TNF-αwere measured by RIA in 257 type 2 diabetic patients and 43 control subjects. Meanwhile, we observed the difference of blood lipid,HbA1c CRP,PAI-1,IL-1,IL-2,IL-6,IL-8 and so on in each group. The measurement data was analyzed by SPSS11.5.Results①The TNF-αlevel in patients of T2DM with MS is significantly increased compared with patients of T2DM without MS, and the TNF-αlevel in patients with T2DM is higher than the control group(P<0.01或P<0.05).②The prevalence of macro-vascular complication in group MS is 60.9%, and in group NMS is 45.8%, the difference is significant (P<0.05). The prevalence of NAFLD in group MS is 39.1%, and in group NMS is 15.7%(P<0.01).③Bivariable Correlations showed there was a positive correlation between the serum TNF-αlevel and TG,TCH,FFA,FCP,IL-1,IL-2,IL-6,IL-8. Multiple regression showed WHR,TG,LDL-C,IL-1,IL-2,IL-6 were equal predictor of serum TNF-αlevel.Conclusions The level of serum TNF-αin the patients with T2DM is higher compared with control group. The level of serum TNF-αin the T2DM patients with MS is higher than the T2DM patients without MS. This indicates serum TNF-αplays an important role in T2DM, and it may influence the compositions of MS. Multiple regression showed WHR,TG,LDL-C,IL-1,IL-2,IL-6,IL-8 were equal predictors of serum TNF-αlevel. In the group MS (T2DM with MS), the prevalence of macro-vascular complication and NAFLD is significantly increased compared with the group NMS (T2DM without MS), this indicates that the disorder of metabolism and inflammation play an important role in the complications of T2DM. The treatment of T2DM is not only a good control of blood glucose, but also the recommended standards of weight control and the level of blood lipid and inflammation, try our best to decrease the morbidity of T2DM and its complications, improve people's quality of life.