Profile of the Immune and Inflammatory Response in Individuals With Prediabetes and Type 2 Diabetes
Profile of the Immune and Inflammatory Response in Individuals With Prediabetes and Type 2 Diabetes
复制标题
DOI：
10.2337/dc14-3008
复制
发表时间：
2015-07-01
期刊：
影响因子：
16.2
通讯作者：
Wild, Philipp S.
中科院分区：
文献类型：
--
作者：
Grossmann, Vera;Schmitt, Volker H.;Wild, Philipp S.
目的 2 型糖尿病中炎症和免疫系统发生改变。本研究的目的是在大量具有代表性的样本中分析糖尿病前期和糖尿病患者的免疫和炎症反应。 研究设计和方法 基于人群的古腾堡健康研究总共分析了 15,010 名个体。根据 HbA(1c) 浓度和诊断史对血糖状态进行分类。对所有样本进行白细胞 (WBC)、粒细胞、淋巴细胞、单核细胞、血小板、C 反应蛋白 (CRP)、白蛋白、纤维蛋白原和血细胞比容分析。在亚队列中测定白细胞介素 18 (IL-18)、IL-1 受体拮抗剂 (IL-1RA) 和新蝶呤浓度。 结果总共分析了 7,584 名男性和 7,426 名女性（年龄范围为 35-74 岁），其中分别有 1,425 名和 1,299 名患有糖尿病前期和糖尿病。生物标志物显示出从血糖正常到糖尿病前期受试者的不同动态：1) 逐渐增加（白细胞、粒细胞、单核细胞、IL-1RA、IL-18 和纤维蛋白原），2) 仅随着亚临床疾病而增加（淋巴细胞和 CRP），3) 从糖尿病前期到仅糖尿病（新蝶呤）增加，4) 不随血糖状态（血细胞比容）而变化。 CRP、IL-1RA 和纤维蛋白原浓度的相对差异最强。一些炎症和免疫标记物与血糖状态相关，独立于心血管危险因素和合并症，随疾病严重程度和糖尿病亚组中疾病特异性并发症的存在而变化。结论炎症和免疫生物标记物谱随 2 型糖尿病的发生和进展而变化。炎症和免疫标志物能够区分疾病的早期临床前阶段和临床阶段、疾病并发症和进展。
OBJECTIVEThe inflammatory and immune systems are altered in type 2 diabetes. Here, the aim was to profile the immune and inflammatory response in subjects with prediabetes and diabetes in a large population-representative sample.RESEARCH DESIGN AND METHODSIn total, 15,010 individuals were analyzed from the population-based Gutenberg Health Study. Glucose status was classified according to HbA(1c) concentration and history of diagnosis. All samples were analyzed for white blood cells (WBCs), granulocytes, lymphocytes, monocytes, platelets, C-reactive protein (CRP), albumin, fibrinogen, and hematocrit. Interleukin-18 (IL-18), IL-1 receptor antagonist (IL-1RA), and neopterin concentrations were determined in a subcohort.RESULTSIn total, 7,584 men and 7,426 women were analyzed (range 35-74 years), with 1,425 and 1,299 having prediabetes and diabetes, respectively. Biomarkers showed varying dynamics from normoglycemic via subjects with prediabetes to subjects with diabetes: 1) gradual increase (WBCs, granulocytes, monocytes, IL-1RA, IL-18, and fibrinogen), 2) increase with subclinical disease only (lymphocytes and CRP), 3) increase from prediabetes to diabetes only (neopterin), and 4) no variation with glucose status (hematocrit). The strongest relative differences were found for CRP, IL-1RA, and fibrinogen concentrations. Several inflammatory and immune markers were associated with the glucose status independent from cardiovascular risk factors and comorbidities, varied with disease severity and the presence of disease-specific complications in the diabetes subcohort.CONCLUSIONSThe inflammatory and immune biomarker profile varies with the development and progression of type 2 diabetes. Markers of inflammation and immunity enable differentiation between the early preclinical and clinical phases of the disease, disease complications, and progression.