Improvement of Interleukin Profiles in Patients with Type 2 Diabetes Mellitus After Add-on Acarbose Therapy Independent of Glycemic Control
|School||Dalian Medical University|
|Keywords||type 2 diabetes interleukin acarbose|
Objective: To study the effects of acarbose add-on current therapy on serum levels of interleukin-4 (IL-4), interleukin-6 (IL-6) and interleukin-10 (IL-10) in patients with type 2 diabetes mellitus.Methods: Sixty-six patients with type 2 diabetes mellitus (T2DM), who did not take acarbose for the previous four weeks, were selected from our institution. Thirty-three healthy volunteers were selected as healthy control group. After excluding those of inadequate samples, 34 patients with T2DM were randomly allocated into group A (acarbose, 50 mg tid, po. was added to current therapy), and 32 patients with T2DM were enrolled into group B (apart from acarbose other hypoglycemic approaches were similar with group A). For both of the diabetic groups, serum samples at the time of enrollment and at the end of 4 weeks intervention were collected and stored in refrigerator at -80℃until analysis. Hypoglycemic therapy otherwise acarbose 50mg three times daily in Group A was titrated the same way according to the level of glycemia. Serum of 33 healthy subjects were enrolled as group C (the healthy control), and the subjects should be without diabetes mellitus, no history of hypertension, and no family history of hypertension, without acute infections and gastrointestinal diseases. Analysis of biochemical indexes was taken in central lab of our institution, and IL-4, IL-6 and IL-10 were determined with commercial ELISA kits.Results:1. The age, BMI and biochemical indexes in the three groups conformed to the characteristics of nondiabetic health and type 2 diabetes mellitus, and those in the two diabetic groups were comparable. The fasting blood glucose (FBG), HbA1C and Low-density lipoprotein cholesterol (LDL-C) significantly decreased after intervention, and no difference between the two diabetic groups was found.2. The baseline levels of IL-4 (4.73±1.98 pg/ml) and IL-10 (1.61±0.65 pg/ml) in healthy control group were significantly higher than in diabetic groups, while the baseline level of IL-6 (1.46±0.61 pg/ml) was significantly lower than that in diabetic groups (P<0.05).3. After four weeks of intervention, IL-6 (t=7.704, P=0.000) decreased while IL-4 (t=-2.228, P=0.033) and IL-10 (t=-9.359, P=0.000) increased significantly in group A. In group B, IL-6 (t=2.713, P=0.011) decreased, and IL-10 (t=-2.972, P=0.006) increased significantly, but IL-4 (t=-1.435, P=0.161) didn’t increase significantly.4. Repeated measurement analysis for simple linear model showed that after four weeks of intervention, after corrections of the gender, age, FBG, postprandial blood glucose (PBG), BMI and HbA1C, IL-6 [F(1,53)=10.371, P=0.002] decreased more while IL-10 [F(1,53)=16.829, P=0.000] increased more in group A than in group B. Although IL-4 increased in both group A and group B, the trend was not statistically different [F(1,53)=1.487, P=0.228].Conclusions:1. The levels of IL-4 and IL-10 decrease while the level of IL-6 increases in patients with type 2 diabetes mellitus.2. Add-on acarbose therapy in patients with diabetes can signicantly improve the imbalance of some interleukins.