重新审视针对 2 型糖尿病低度炎症的白细胞介素-6 和胰高血糖素样肽-1 标志物:一项荟萃分析和我们的实验室经验。

IF 3.1 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Acta Diabetologica Pub Date : 2024-10-30 DOI:10.1007/s00592-024-02398-8
Jyoti Kiran Bara, Puneet Gandhi, Pramod Verma
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引用次数: 0

摘要

目的:2 型糖尿病(T2DM)表现为胰腺功能紊乱,这是白细胞介素-6(IL-6)水平升高导致的低度全身炎症的结果。这反过来又与循环 GLP-1 水平降低导致的增量素效应减弱有关。因此,监测循环 IL-6 和 GLP-1 水平对于更好地管理 T2DM 患者并改善其预后非常重要:由于有关 T2DM 患者 GLP-1 和 IL-6 循环浓度的文献研究有限,我们从 3 个数据库中筛选出 1558 项研究进行了荟萃分析。根据纳入和排除标准,对这些研究进行了这两个指标的筛选,并绘制了标准化均值差异森林图,从数据集中推导出中值。同时,还通过 ELISA(n = 52 名 T2DM 患者)对标记物的表达水平进行了实时分析:结果:荟萃分析结果表明,T2DM 患者的免疫球蛋白表达水平(P)显著高于T2DM患者:该研究强调,IL-6 和 GLP-1 的全身浓度与 T2DM 患者的持续低度炎症和增量素效应下降相对应,表现为胰腺 β 细胞功能障碍。这两种标志物的表达呈反比,监测它们的水平对于通过潜在的拮抗剂对其进行靶向治疗具有重要的临床意义,从而降低并发症的风险,提高患者的生活质量。
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Revisiting the markers interleukin-6 and glucagon-like peptide-1 for targeting low-grade inflammation in type 2 diabetes: a meta-analysis and our lab experience.

Aim: Type 2 diabetes (T2DM) manifests as pancreatic disorder as a consequence of low-grade systemic inflammation, attributed to upregulated levels of interleukin-6 (IL-6). This in turn is associated with a reduced incretin effect with lower circulatory GLP-1 levels. Therefore, its important to monitor the circulating IL-6 and GLP-1 levels for better management and outcomes in T2DM patients.

Methods: Limited studies being available in literature on circulating concentrations of GLP-1 and IL-6 in T2DM patients, a meta-analysis was conducted by identifying 1558 studies from 3 databases. As per inclusion and exclusion criteria, the studies were screened for the 2-markers.Forest plots were drawn for standardized mean differences and median values were deduced from the datasets. In parallel, analysis was conducted to ascertain the expression levels of the markers by ELISA (n = 52 T2DM patients) in real time.

Results: The meta-analysis showed a significant (p < 0.01) standardized mean difference of 3.82 and 1.04 for IL-6 and GLP-1 respectively. The median values obtained from analysis for IL-6 were 26.50 pg/ml which were higher than the controls downregulated levels of GLP-1(8.77 pg/ml) were noted. The above findings are corroborated by the results of our experimental analysis with IL-6 concentrations at 11.603pg/ml and GLP-1 at 13.05pg/ml.

Conclusion: The study highlights that systemic concentrations of IL-6 and GLP-1 correspond to a persistent low-grade inflammation and decreased incretin effect in T2DM patients which manifest as pancreatic β-cell dysfunction. The expression of the markers is inversely correlated and monitoring their levels is clinically important for targeting them through their potential antagonists thus reducing the risk of complications, thereby improving the quality of life of the patients.

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来源期刊
Acta Diabetologica
Acta Diabetologica 医学-内分泌学与代谢
CiteScore
7.30
自引率
2.60%
发文量
180
审稿时长
2 months
期刊介绍: Acta Diabetologica is a journal that publishes reports of experimental and clinical research on diabetes mellitus and related metabolic diseases. Original contributions on biochemical, physiological, pathophysiological and clinical aspects of research on diabetes and metabolic diseases are welcome. Reports are published in the form of original articles, short communications and letters to the editor. Invited reviews and editorials are also published. A Methodology forum, which publishes contributions on methodological aspects of diabetes in vivo and in vitro, is also available. The Editor-in-chief will be pleased to consider articles describing new techniques (e.g., new transplantation methods, metabolic models), of innovative importance in the field of diabetes/metabolism. Finally, workshop reports are also welcome in Acta Diabetologica.
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