CD8+CD25+FoxP3+调节T细胞在新诊断2型糖尿病患者外周血中的变化及其临床意义

The changes and clinical value of CD8+CD25+FoxP3+regulator T cells in peripheral blood of patients with newly diagnosed type 2 diabetes

目的 探讨外周血CD8+CD25+FoxP3+调节T细胞(CD8+Treg)在新诊断T2DM发病过程中的比例变化及意义.方法 选取2018年7~12月于我院内分泌科就诊的新诊断T2DM患者62例,其中肥胖患者30例(OB组,BMI≥28 kg/m2),非肥胖患者32例(T2DM组,BMI<28 kg/m2).选取同期于我院健康体检人群32名为正常对照组(NC).采用流式细胞仪分析外周血CD8+Treg比例;实时定量PCR检测外周血单个核细胞(PBMCs)FoxP3 mRNA水平.结果 与NC组比较,OB组外周血CD8+Treg细胞比例及PBMCs FoxP3 mRNA均降低(P<0.05).OB组外周血CD8+Treg细胞比例与PBMCs FoxP3 mRNA水平(r=0.382,P=0.037)呈正相关,与胰岛素抵抗指数、FIns水平呈负相关(r=-0.421、-0.393,P=0.020、0.032).Logistic回归分析显示,CD8+Treg可能是T2DM伴IR的保护因素(OR=0.637,95%CI 0.432~0.938).结论 新诊断T2DM患者外周血CD8+Treg细胞比例降低可能在T2DM发病过程中起重要作用.

Objective To investigate the change and significance of CD8^+CD25^+FoxP3^+regulatory T cells(CD8^+Treg)in newly diagnosed type 2 diabetic patients with newly diagnosed type 2 diabetic patients(T2DM).Methods trols.T2DM patients were divided into two subgroups according to the body mass index(BMI):patients with BMI≥28 kg/m^2(OB group,n=30)and patients with BMI<28 kg/m^2(T2DM group,n=32).The percentage of CD8^+Treg in peripheral blood was analyzed by flow cytometry,and the expression of FoxP3 mRNA in peripheral blood mononuclear cells(PBMCs)was detected by real-time quantitative PCR.The percentages of CD8^+Treg cells in peripheral blood and the expression of PBMCs FoxP3 mRNA were significantly decreased in OB group than in NC group(P<0.05).The percentage of CD8^+Treg cells in peripheral blood was positively correlated with the level of PBMCs FoxP3 mRNA in OB group(r=0.382,P=0.037),while negatively correlation with insulin resistance(IR)index(r=―0.421,P=0.020)and fasting serum insulin(r=―0.393,P=0.032).Logistic regression analysis suggested that CD8^+Treg might be a protective factor for T2DM and IR(OR=0.637,95%CI 0.432~0.938).Conclusion The decrease of CD8^+Treg cells may play an important role in patients with newly diagnosed T2DM.