2型糖尿病患者体液免疫、细胞免疫变化与胰岛素敏感性的相关性分析

An investigation on the correlation between the changes of humoral and cellular immunity and insulin sensitivity in patients with type 2 diabetes

目的探讨2型糖尿病患者体液免疫、细胞免疫变化与胰岛素敏感性的相关性。方法回顾性选取2014年1月-2015年12月中南大学湘雅医院附属海口医院内分泌科收治的250例2型糖尿病患者作为2型糖尿病组,另选250例同期健康人群作为对照组。比较2组体液免疫、细胞免疫及糖代谢指标水平;并采用Pearson相关系数分析血清IgA、IgM、全血Th17、Treg水平与胰岛素敏感性的相关性。结果2型糖尿病组血清IgA、全血Th17、FPG、HbA1c及HOMA-IR水平均高于对照组(P<0.05);血清IgM、全血Treg水平均低于对照组(P<0.05)。血清IgA与FPG、FINS、HbA1c、HOMA-IR呈正相关(r=0.350;0.319;0.347;0.339,P<0.05);血清IgM与FPG、FINS、HbA1c、HOMA-IR呈负相关(r=-0.275,-0.303,-0.317,-0.323,P<0.05);全血Th17与HbA1c、HOMA-IR呈正相关(r=0.430;0.442,P<0.05);全血Treg与HOMA-IR呈负相关(r=-0.041,P<0.05)。结论相对于健康人群,2型糖尿病患者体液免疫、细胞免疫相对失调,这与FPG、FINS、HbA1c水平升高及胰岛素抵抗密切相关,检测体液免疫、细胞免疫指标水平有助于评估2型糖尿病患者免疫功能及胰岛素敏感性。

Objective To investigate the correlation between the changes of humoral and cellular immunity and insulin sensitivity in patients with type 2 diabetes.Methods From January 2014 to December 2015,250 patients with type 2 diabetes who were admitted to the department of endocrinology,Haikou Hospital Affiliated to the Xiangya Hospital of Central South University,were retrospectively selected as the type 2 diabetes group,and another 250 healthy people in the same period were selected as the control group.The index levels of the humoral immunity,cellular immunity and glucose metabolism were compared between the two groups.The correlation between the levels of the serum IgA,IgM,whole blood Th17,Treg and the insulin sensitivity was analyzed by the Pearson correlation coefficient.Results The levels of the serum IgA,whole blood Th17,FPG,HbA1c and HOMA-IR in the type 2 diabetes group were higher than those in the control group(P<0.05),while the levels of the serum IgM and whole blood Treg were lower than those in the control group(P<0.05).The serum IgA was positively correlated with the FPG,FINS,HbA1c and HOMA-IR(r=0.350;0.319;0.347;0.339,P<0.05),while the serum IgM was negatively correlated with FPG,FINS,HbA1c and HOMA-IR(r=-0.275,-0.303,-0.317,-0.323,P<0.05).The whole blood Th17 was positively correlated with HbA1c and HOMA-IR(r=0.430;0.442,P<0.05),while the whole blood Treg was negatively correlated with HOMA-IR(r=-0.041,P<0.05).Conclusion Compared with healthy people,the humoral immunity and cellular immunity of type 2 diabetic patients are relatively unbalanced,which is closely related to the elevated levels of the FPG,FINS,HbA1c and the insulin resistance.Detecting the index levels of the humoral immunity and cellular immunity is helpful to evaluate the immune function and insulin sensitivity of type 2 diabetes patients.