The Role Of Macrophage Migration Inhibitory Factor In Patients With Cerebral Infarction Caused By The Abnormal Glucose Metabolism

Objective: In recent years, diabetes is higher year by year along with lifestyle changes, becoming the common risk factors for cerebrovascular disease. Clinical studies have shown that stroke mortality, morbidity, recurrence rates are relatively high, the condition of recovery is weak compared with non-diabetic population with diabetes.Impaired glucose tolerance (IGT) and impaired fasting glucose regulation (IFG) are behalf of the intermediate state between a normal glucose homeostasis and diabetes/high blood sugar metabolism, is high-risk predisposing factor of type 2 diabetes .Research suggests that patients with IGT have been the risk of cerebral vascular accident, In the IGT stage, the complex relations have been fully exposed, abnormal glucose metabolism, insulin resistance, hyperinsulinemia, endothelial cell dysfunction, oxidative stress, lipid abnormalities, high blood pressure, etc. and then woven together,leading to target organ damage.Glucose metabolism in patients with cerebrovascular disease state is an important prognostic and prediction factor.Macrophage migration inhibitory factor (MIF),a multi-inflammatory cytokine,whose main role is to inhibit macrophage migratory movement, the promotion of macrophages in the inflammatory infiltration, aggregation, activation and secretion of some cytokines such as IL - 1, TNF-α, NO, etc., so M IF in macrophages involved in the regulation of various diseases, especially atherosclerosis play an important role.Therefore, the study of hyperglycemia especially impaired glucose regulation and the expression of bFGF in acute cerebral infarction is beneficial to the prevention and treatment of cerebral ischemic with hyperglycemia. Methods:. Choose 90 patients with acute cerebral infarction from March 2009 to November 2009 in the Second Hospital of Hebei Medical University, Department of Neurology, aged 45- 85 year-old. Diabetes-Acute cerebral infarction group (DACI group), 30caces; Impaired glucose regulation -Acute cerebral infarction group (IGACI group), 30caces; Patients to hospital out-patient clinics for the same period of the 30 cases of healthy persons, aged 45- 85 year-old, Normal blood glucose-Acute cerebral infarction group (NGACI group), 30caces.In all cases in line with①1995 for the fourth National Conference on Cerebrovascular Diseases to develop a "brain disease diagnostic criteria", characterized by cranial CT or MRI confirmed cerebral infarction, the incidence were within 3 d.②coincide with the 1999 WHO Expert Committee Report issued in consultation: fasting plasma glucose (FPG) 3.9-6.0 mmol / L normal; 6.1 - 6.9mmol / L for IFG;≥7.0mmol / L for the diabetic group; OGTT using 75 g anhydrous glucose load, OGTT2h≤7.7mmol / L for normal, OGTT2h 7.8 - 11.0mmol / L for IGT,≥11.1mmol / L of diabetes.Detect the peripheral blood levels of MIF of each acute cerebral infarction group and the normal control group, and compare the differences expression of serum MIF in DACI group, IGACI group, NGACI group and NC group. Detect the peripheral blood levels of fasting plasma glucose and blood lipids of each acute cerebral infarction group and the normal control group by biochemics method, in order to compare the differences blood levels of fasting plasma glucose and blood lipids in DACI group, IGACI group, NGACI group and NC group.Glucose metabolism: the undiagnosed diabetic patients were treated with oral glucose tolerance test (OGTT), In patients with acute ischemic cerebrovascular disease are required after admission (14±2) days to OGTT test, Only FPG and the OGTT test blood glucose 2h after glucose load (2hPG) two points.Results:1 In DACI group, IGACI group, NGACI group and NC group, age and gender are no significantly different (P> 0.05).2 The serum MIF concentration of is non-normal distribution (skewness coefficient = 2.312 peak skewness = 8.691);in DACI group, IGACI group, NGACI group ,the mean scores of MIF levels in serum are (0.535;0.535;0.367),which are higher than the mean score of MIF levels in serum in the NC group (0.273), the difference is statistically significant (P <0.05); in DACI group and IGACI group, the mean scores of MIF levels in serum are different, but the difference is no statistically significant (P> 0.05); the mean scores of MIF levels in DACI group and IGACI group are lower than the mean score of MIF level in NGACI group, the difference is statistically significant (P <0.05).3 The mean scores of CHOL, TG ,LDL levels in DACI group, IGACI group and NGACI group (5.856,3.042,3.394;5.308,3.085,3.193;5.351,3.111,3.271) are higher than the mean scores of CHOL, TG levels in NC group (3.853,1.128,2.563), the difference is statistically significant (P <0.05); the mean scores of CHOL, TG, LDL levels in DACI group, IGACI group, and NGACI group are different, but the difference is no statistically significant (P> 0.05).4 The mean scores of HDL levels in DACI group, IGACI group and NGACI group (1.394;1.415;1.478) are lower than the mean scores of HDL levels in NC group (1.718), the difference is statistically significant (P <0.05); the mean scores of HDL levels in DACI group, IGACI group, and NGACI group are different, but the difference is no statistically significant (P> 0.05).5 The mean score of fasting plasma glucose level in serum in DACI group (8.659) is higher than the mean score of fasting plasma glucose level in serum in IGACI group (6.069), the difference is statistically significant (P <0.05); the mean scores of fasting plasma glucose levels in serum between NGACI group (4.741) and the NC group (4.970) are different, but the difference is no statistically significant (P> 0.05); the mean scores of fasting plasma glucose levels in DACI group and IGACI group are higher than the mean scores of fasting plasma glucose levels in NGACI group and NC group, the difference is statistically significant (P <0.05). 6 In DACI group, IGACI group, NGACI group and NC group, the MIF levels in serum are not associated with age and there is not a statistically significant correlation (P> 0.05).7 In the over all,level of MIF with CHOL, TG there is a significant correlation (P <0.05), and LDL, HDL had no significant correlation (P> 0.05).Conclusions:1 DACI group, IGACI group, NGACI group are significantly higher than NC group by levels of serum MIF, indicating in the cerebral infarction, MIF increased expression may be involved in nerve tissue after infarction in the inflammatory process; DACI group, IGACI group serum MIF is no significant difference, indicating the level of MIF expression in blood glucose level is no significant correlation; DACI group, IGACI serum MIF level is significantly higher than NGACI group, indicating cerebral glucose metabolic abnormalities increase the expression of pro-inflammatory cytokines and increased the extent of cerebral infarction.2 DACI group blood glucose is significantly higher than IGACI group, but the DACI group serum MIF levels IGACI group is no significant difference, indicating even the stage of abnormal glucose regulation in brain tissue has been a significant injury, its harmful effects, and is similar to diabetes.Therefore, attention should be given abnormal glucose regulation stage, to strengthen the control of blood sugar, prevent the occurrence of cerebral ischemia.3 DACI group, IGACI group, NGACI group of CHOL, TG, LDL levels are significantly higher than the NC group, HDL levels significantly lower than the NC group, indicating increased cerebral blood lipid abnormalities. High blood sugar and high blood lipids are closely related to the interactions between them and increased the brain damage.4 In DACI group, IGACI group, NGACI group and NC group, are not found in serum MIF levels and age, there is a significant correlation.5 MIF with the overall level of CHOL, TG are significantly associated with LDL, HDL no significant correlation, indicating the changes in MIF and CHOL, TG consistent with the change, suggesting abnormal blood lipid of the MIF can increase the changes of cerebral infarction, indirect through the MIF to influence local cerebral inflammatory response.