Tfh及IL-2与IL-17在老年2型糖尿病患者外周血中的变化及其临床意义

Changes of Tfh and IL-2 and IL-17 in the peripheral blood of elder type 2 diabetes mellitus and their clinical implications

探讨老年2型糖尿病(type 2diabetes mellitus,T2DM)患者滤泡辅助性T细胞(follicular helper T cell,Tfh)、CD3^+T细胞、CD4^+T细胞、CD8^+T细胞、NK细胞的数量变化以及IL-2和IL-17等细胞因子含量差异并与患者血糖水平做相关性分析。采用流式细胞仪检测100例老年T2DM患者外周血CD3^+T细胞、CD4^+T细胞、CD8^+T细胞、NK细胞水平并与150例老年非糖尿病患者进行比较。分析淋巴细胞亚群与患者空腹血糖(fasting plasma glucose,FPG)、餐后2h血糖(2hour plasma glucose,2hPG)、糖化血红蛋白(glycosylated hemoglobin,HbA1C)、胰岛素抵抗指数(homeostasis model assessment-insulin resistance,HOMA-IR)及胰岛β细胞功能指数(homeostasis model assessment beta,HOMA-β)之间的相关性;采用ELISA方法检测外周血IL-2和IL-17水平。老年T2DM患者外周血中CD3^+T细胞、CD4^+T细胞、CD4^+T细胞/CD8^+T细胞的比值以及NK细胞均低于健康对照组,并与血糖呈负相关。老年T2DM患者外周血Tfh、CD8^+T细胞以及IL-17水平均高于健康对照组。老年T2DM的发病机制可能是随着年龄增高与长期高血糖导致免疫功能异常,外周血CD4^+T细胞/CD8^+T细胞水平下降以及Tfh和IL-17水平增高进一步加剧了细胞和体液免疫调节紊乱,致使胰岛细胞不断被破坏。

We investigated the change of cellular immune function in elder type 2 diabetes mellitus（T2DM）patients and its relation with fasting plasma glucose（FPG）,2 hour plasma glucose（2 hPG）,glycosylated hemoglobin（HbA1C）,HOMA-IR and HOMA-β.150 healthy controls and 100 T2DM patients in Yixing area were enrolled in this study.Peripheral blood T-lymphocyte subsets were measured by flow cytometery.Correlation analysis was employed to analyze the relationship among CD4-＋/CD8-＋to FPG,2 hPG,HbA1C,HOMA-IR,HOMA-β.ELISA was used to test the serum IL-2 and IL-17 levels.The results showed that the percentages of CD3-＋T,CD4-＋T,CD4-＋/CD8-＋T and NK of T2DM patients were lower than those of the healthy controls and CD4-＋/CD8-＋T cells were negatively correlated with FPG,2 hPG,HbA1C,HOMA-IR and HOMA-β.The percentages of CD8-＋T,Tfh and IL-17 were higher than those of the healthy controls.These findings suggest that decrease of CD4-＋/CD8-＋T level in peripheral blood and the disorder of cellular and humoral immune regulation may be involved in the pathogenesis of elder type 2 diabetes mellitus.