| Interleukin -6 (IL-6) is a pleiotropic cytokine involved in a variety of human biological processes. Type 2 diabetes mellitus (T2DM) is a chronic inflammatory status. IL-6 as an inflammatory factor, its relationship with T2DM has become a hot research. The emergence of chronic complications of diabetes, a serious impact on the quality of life of patients, platelet plays an important role in vascular complications of T2DM.T2DM is a chronic inflammatory status, as inflammatory cytokines, IL-6 may be involved in such status. Study found that patients with T2DM the level of serum TNF-a and IL-6 are more than non-DM healthy people, and all inflammatory markers and insulin sensitivity index was negatively with IL-6. Levels of CRP and IL-6 can predict the development of T2DM in female patients.The main mechanisms of IL-6 causing disorders of glucose metabolism are as follows: (1) IL-6/IL-6R cause SOCS1 / 3 to increase, SOCS-3 is a competitive combination of the IR tyrosine residue 960, so that downstream disruption of insulin signaling;SOCS-3 could serve as a connector protein,combined with ubiquitin and IRS, reducing the level of the IRS;IL-6/IL-6R can be combined with cells to promoteα-cell proliferating,inhibitingα-cell's apoptosis;IL-6R and leptin receptor belong to the same receptor family cytokines,IL-6 and leptin have the same transduction pathway,can be competitive with leptin combined to STAT,leading to leptin resistance. (2) adipose tissue:①IL-6 treatment-mediated reduction of IRS-1 protein expression and insulin-stimulated tyrosine phosphorylation is the main reason for insulin resistance.②Low plasma adiponectin is an independent risk factor for development of T2DM,rhIL6 inhibit SW872 adipocytes adiponectin mRNA expression and protein secretion,rhIL6 reduce gene expression of Adipo R.③insulin induced IL-6 gene expression and IL-6 synthesis and release through the cGMP / cGMP-dependent protein kinase / cAMP response element-binding protein and the MAPK pathway .(3) of the liver: study shows that IL-6 occurred in the liver cause insulin resistance and suppression of the insulin signaling pathway. High blood sugar can stimulate vascular endothelial cells and peripheral mononuclear cells increase secretion of IL-6,and IL-6 increased the secretion of CRP,CRP have the closed relationship with T2DM. (4) of skeletal muscle: IL-6-mediated insulin resistance in skeletal muscle has three mechanisms: JNK1 / 2 activation; socs3mRNA aggregation;protein tyrosine phosphatase 1B (PTP1B) activity increased. (5) IL-6 gene polymorphism: T2DM associated with IL-6 gene polymorphism mainly concentrated in the promoter region of the-174G / C,-573G / C,-597G / A site,the results are different .Developed to a certain period of T2DM,vascular complications can occur.Abnormal platelet function plays an important role in the process of vascular disease and development in T2DM. Patients with T2DM significantly have increased MPV , MPV are higher in complications of T2DM than non-complications.The main mechanism for Platelet activation in T2DM are:(1) thromboxane A2 synthesis increased,TXA2 is a potential activator of platelets, platelet activation in diabetic patients is the earliest abnormal changes. (2) adhesion molecule expression and receptors: platelet storage granules within a series of adhesion molecules, when the platelet activation,these molecules express on the platelet membrane. (3) in patients with T2DM there is a GPIIb / IIIa enhanced activity. (4) status of high glucose,higher HbA1C can damage the endothelial cell function,the synthesis of PGI2,NO are decreased. (5) diabetic patients exists enhanced oxidative stress,the process resulted in too many clusters of reactive oxygen species (ROS),changes in calcium homeostasis and increased protein tyrosine phosphorylation. (6) the platelet sensitivity to insulin is decreased, resulting in increasing in P2Y12.IL-6 can promote the stem cells to differentiate to the megakaryocyte and to promote the platelet function. IL-6 cause hematopoietic stem cells to shorten the G0 period,to accelerate the proliferation and differentiation of stem cells.Our objective are patients with T2DM,divided into two groups: with complications group and without complications group,select age-matched healthy people as control group, patients record their sex,age,BMI and other general information. Measurement of FBG, HbA1C,TG,TC,PLT,PCT, PDW,MPV and serum concentration of IL-6. The results show that,in T2DM group,blood IL-6 concentration was significantly higher than the healthy control group, the difference has statistical significance (P <0.05),and IL-6 concentration was positively correlated with the duration and BMI,there is statistically significant difference (P < 0.05). Complications have higher concentration of IL-6 than non-complications in diabetic group,has statistically significant difference (P <0.05),and IL-6 in the presence of microvascular complications is higher than the concentration of large vascular complications group. MPV is higher in T2DM group,MPV was positively correlated with HbA1C.There is no significant difference between the complications group and non-complications group. IL-6 concentration was no significant correlation with the MPV.These results suggest that IL-6 involved in the occurrence of T2DM and its complications occurrence.In patients with T2DM given IL-6 antagonist may have benefits for the blood glucose control and the complications of T2DM. Platelet activation exist in T2DM,considering primarily related to bad blood glucose control,MPV can reflect changes in blood glucose. |
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