新诊断2型糖尿病患者外周血OX40^(+)Tfh细胞与胰岛素抵抗的相关性研究

Relationship between OX40^(+) follicular helper T cells in the peripheral blood of patients with newly diagnosed type 2 diabetes mellitus and insulin resistance

目的:探讨OX40在新诊断2型糖尿病(T2DM)患者外周循环滤泡辅助性T细胞(cTfh)表面的表达特性及其与胰岛素抵抗(IR)的相关性。方法:选取2020年11月至2021年12月于苏州大学附属第一医院内分泌科住院的新诊断T2DM患者,并选取同时期体检中心的健康志愿者作为对照。测量研究对象身高、体重并计算体重指数(BMI),收集研究对象空腹血糖(FPG)、空腹胰岛素(FINS)等,并计算血清胰岛素曲线下面积(AUC_(INS))和稳态模型评估胰岛素抵抗指数(HOMA-IR)等,检测研究对象外周血中cTfh细胞比例及其表面OX40的表达。采用t检验或χ^(2)检验进行组间比较,采用Pearson相关分析法分析HOMA-IR与临床指标的相关性,采用多重线性回归分析法分析HOMA-IR的影响因素。结果:共纳入160例研究对象。其中,T2DM组96例,对照组64名。与对照组相比,T2DM组OX40^(+)Tfh细胞比例升高,分别为(3.95±1.62)%和(7.51±5.32)%,差异具有统计学意义(t=4.29,P=0.006)。Pearson相关分析结果显示,HOMA-IR与OX40^(+)Tfh细胞比例(r=0.569)、BMI(r=0.450)和AUC INS(r=0.341)均呈正相关(P均<0.001)。多重线性回归分析结果显示,OX40^(+)Tfh细胞比例(B=0.284,95%CI 0.029~0.538,P=0.017)、BMI(B=0.249,95%CI 0.030~0.486,P=0.022)增加均对新诊断T2DM患者IR程度造成独立的正向影响。结论:T2DM患者cTfh表面OX40上调表达,OX40^(+)Tfh细胞比例增加可能是影响新诊断T2DM患者IR的独立危险因素。

Objective To investigate the relationship between the expression of OX40 on circulating follicular helper T cells(cTfh)in newly diagnosed type 2 diabetes and insulin resistance.Methods The newly diagnosed T2DM patients hospitalized in the First Affiliated Hospital of Soochow University from November 2020 to December 2021 were selected,and the healthy volunteers in the physical examination center during the same period were selected as the control.The height and weight of the subjects were measured,and the body mass index(BMI)was calculated.The subjects′fasting plasma glucose(FPG)and fasting serum insulin(FINS)were collected,and the area under the serum insulin curve(AUC_(INS))and homeostasis model assessment of insulin resistance(HOMA-IR)were calculated.The proportion of cTfh cells in the peripheral blood and the expression of OX40 on the surface of cTfh cells were detected.T-test or χ^(2) test was used to compare the indexes between the two groups.Pearson correlation analysis was used to analyze the correlation between HOMA-IR and clinical indicators,and multiple linear regression was used to analyze the influencing factors of HOMA-IR.Results A total of 160 subjects were included.There were 96 cases in T2DM group and 64 cases in control group.The expression of OX40 on cTfh cells in T2DM(7.51±5.32)%was significantly higher than that in control group(3.95±1.62)%,and the difference was statistically significant(t=4.29,P=0.006).Pearson correlation analysis showed that HOMA-IR was positively correlated with the ratio of OX40^(+)Tfh cells(r=0.569),BMI(r=0.450)and AUC_(INS)(r=0.341),(P<0.001),respectively.Multiple linear regression showed that the increase of OX40^(+)Tfh cells(B=0.284,95%CI 0.029-0.538,P=0.017)and BMI(B=0.249,95%CI 0.030-0.486,P=0.022)had independent positive effects on the degree of insulin resistance in newly diagnosed T2DM.Conclusions OX40 was up-regulated on the surface of cTfh in T2DM patients.Moreover,the increase of OX40^(+)Tfh cells might be an independent risk factor of insulin resistance in patient with newly diagnosed type 2 diabetes.