Clinical Research Of The Relationship Between Nuclear Factor-κB And Macroangiopathy In Type 2 Diabetics

Objective: To investigate the relationship between NF kappa-B (NF-κB) and the development of diabetic macroangiopathy in patients with type 2 diabetes, we compare the expression level of Nuclear Factor-κB in mononuclear cell of type 2 diabetes patients with and without macroangiopathy.Methods: Total 20 normal controls(group A, 45%women, mean age, 54.30±7.39years) and 30 diabetic patients without macro-angiopathy (group B, 43%women, mean age, 54.53±9.19years, course, 4.50±3.50years) and 22 diabetic patients with(group C, 45%women, mean age, 56.45±7.30years, course, 6.21±3.88years) macro-angiopathy were recruited, mononuclear cell were separated from whole blood, NF kappa-B (NF-κB) expression level in mononuclear cells were detected by enzyme-linked immunosorbent assay(ELISA) and flow cytometry (FCM).Results: 1.The expression of NF-κB detected by FCM group comparison: Compared with the control group【(3.667±0.376)%】, the expression of NF-κB in diabetics without macro-angiopathy【(10.198±0.467)%】were significantly higher(p<0.01), the expression of NF-κB in diabetics with macro-angiopathy【(15.270±0.820)%】were further higher; compared with the diabetics without macro-angiopathy group, the expression of NF-κB in diabetics with macro-angiopathy were significantly higher(p<0.01).2.The expression of NF-κB detected by ELISA group comparison: Compared with the control group【(263.695±45.746)pg/ml】, the expression of NF-κB in diabetics without macro-angiopathy【(362.777±27.900)pg/ml】were significantly higher(p<0.01), the expression of NF-κB in diabetics with macro-angiopathy【(450.800±24.320)pg/ml】 were further higher; compared with the diabetics without macro-angiopathy group, the expression of NF-κB in diabetics with macro-angiopathy were significantly higher(p<0.01).3.Correlation analysis: Linear correlation analysis showed that the expression level of NF-κB detected by FCM had positive relationship with the expression level of NF-κB detected by ELISA in diabetics(r=0.793, p<0.01); the expression level of NF-κB detected by FCM had positive relationship with FBG, HbA1c and LgHoma-IR(r=0.736, p<0.01; r=0.827, p<0.01; r=0.843, p<0.01); the expression level of NF-κB detected by ELISA had positive relationship with FBG, HbA1c and LgHoma-IR(r=0.526, p<0.01; r=0.531, p<0.01; r=0.76, p<0.01).Conclusion: Increased level of NF-κB in peripheral blood mononuclear might be risk factor for peripheral macroangiopathy in patients with diabetes. Objective: To investigate the anti-inflammatory effects of insulin by observing the effect of short-term intensive insulin therapy on the expression level of Nuclear Factor-κB in peripheral blood mononuclear cell of newly-diagnosed type 2 diabetics.Method: 20 newly-diagnosed type 2 diabetic patients(30%women, mean age (51.25±5.71)years,fasting blood glucose(FBG)(11.18±1.73)mmol/L,postprandial blood glucose(P2hBG)(17.92±2.08)mmol/L) )were treated by intensive insulin therapy for 2 weeks, mononuclear cell were separated from whole blood, NF-κB expression level in mononuclear cells were detected by enzyme-linked immunosorbent assay(ELISA) and flow cytometry (FCM), FBG , P2hBG , white blood cell count(WBC), neutrocyte percents(N%) and fasting serum insulin(FINS) were measured pre-treatment and post- treatment. The other 20 healthy volunteers(45%women; mean age, 54.30±7.39years) served as control subjects.Results1 The expression levels of Nuclear Factor-κB detected by ELISA【(352.11±20.04)pg/mlVS(263.70±45.75)pg/ml】and FCM【(15.53±2.49)%VS (3.67±1.68)%】in mononuclear cell of type 2 diabetes patients were significantly higher than those of control subjects(p<0.01).2 After short-term intensive insulin therapy for 2 weeks,①FBG and P2hBG were significantly decreased, which were(11.18±1.73)mmol/L VS (6.37±1.07)mmol/L and(17.92±2.08)mmol/L VS(8.27±2.12)mmol/L, p<0.01;②WBC and N% were much lower than those of pre-treatment, which were(7.39±1.56)×109/L VS (5.52±1.12)×109/L and (64.61±5.45)% VS(56.23±4.71)%, p<0.01;③Compared to those of pre-treatment, the expression level of Nuclear Factor-κB detected by ELISA【(352.11±20.04)pg/ml VS (331.75±19.20)pg/ml】and FCM【(15.53±2.49)% VS (12.22±2.80)%】in mononuclear cell of type 2 diabetes patients were significantly decreased(p<0.01).3 Correlation analysis: Linear correlation analysis showed that The expression levels of Nuclear Factor-κB detected by ELISA had significant and positive relationship with .The expression levels of Nuclear Factor-κB detected by FCM (r=0.642,p<0.01) ; after 2 weeks of insulin treatment, the descent of Nuclear Factor-κB level detected by FCM had had no relationship with the descent of FBG(r=0.02,p>0.05), P2hBG(r=0.10,p>0.05) and LgHOMA-IR(r=0.23,p>0.05); after 2 weeks of insulin treatment, the descent of Nuclear Factor-κB detected by ELISA had no relationship with the descent of FBG(r=0.37,p>0.05), P2hBG(r=0.25,p>0.05) and LgHOMA-IR(r=0.14,p>0.05).Conclusion: There are existed low-degree of inflammation reaction in type 2 diabetics, Intensive Insulin Therapy can decrease the level of NF-κB in peripheral blood mononuclear cell and reduce the inflammatory reaction.