肠道微生物与2型糖尿病患者T淋巴细胞亚群和炎症因子水平的相关性

Correlation between intestinal microflora and T lymphocyte subsets and inflammatory cytokines in T2DM patients

目的探究肠道微生物与2型糖尿病(T2DM)患者T淋巴细胞亚群和炎症因子水平的相关性。方法选择2019年4月到2022年4月我院收治的94例T2DM患者作为T2DM组,另选体检健康者81例作为对照组,采集所有受试者外周血及粪便样本,检测空腹血糖(FPG)、胰岛素抵抗指数(HOMA-IR)、空腹胰岛素(FINS)、炎症因子IL-6、hs-CRP水平、T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD8^(+))水平和主要肠道菌群丰度,分析主要肠道菌群变化与CD4^(+)/CD8^(+)、IL-6、hs-CRP的关系。结果治疗后T2DM组FBG、FINS、HOMAIR、IL-6、hs-CRP水平均高于对照组(P<0.05),T2DM组CD3^(+)、CD4^(+)、CD8^(+)及CD4^(+)/CD8^(+)比值均低于对照组(P<0.05)。T2DM组肠道双歧杆菌、乳酸杆菌数量、B/E值低于对照组,大肠杆菌、肠球菌数量高于对照组(P<0.05)。Pearson相关性分析显示:T2DM患者双歧杆菌、乳酸杆菌、B/E值与IL-6、hs-CRP水平呈负相关,与CD4^(+)/CD8^(+)比值呈正相关(P<0.05);大肠杆菌、肠球菌数量与IL-6、hs-CRP水平呈正相关,与CD4^(+)/CD8^(+)比值呈负相关(P<0.05)。结论T2DM患者肠道菌群失调、定植力受损,这可能与其能引发患者CD4^(+)/CD8^(+)水平降低和炎症因子IL-6、hs-CRP水平升高有关。

Objective To explore the correlation between intestinal microorganisms and T lymphocyte subsets and inflammatory cytokine levels in patients with type 2 diabetes mellitus(T2DM).Methods Ninety-four patients with T2DM admitted to our hospital from April 2019 to April 2022 were selected as the T2DM group,and another 81 healthy subjects were selected as the control group.Peripheral blood and fecal samples were collected from all the subjects to detect fasting plasma glucose(FPG),fasting insulin(FINS),insulin resistance index(HOMA-IR),inflammatory factors IL-6,hs-CRP content,T lymphocyte(CD3^(+),CD4^(+),CD8^(+))levels and identify the major intestinal bacteria.The relationship between the changes of major intestinal bacteria and the expression of CD4^(+)/CD8^(+),IL-6,and hs-CRP was analyzed.Results After treatment,the expressions of FBG,FINS,HOMA-IR,IL-6 and hs-CRP in T2DM group were higher than those in control group respectively(P<0.05).CD3^(+),CD4^(+),CD8^(+)and CD4^(+)/CD8^(+)in T2DM group were lower than those in control group respectively(P<0.05).The colonies of intestinal bifidobacteria and lactobacilli and B/E in T2DM group were lower than those in control group,while those of Escherichia coli and enterococci were higher than those in control group,respectively(P<0.05).Pearson correlation analysis showed that bifidobacteria,lactobacilli and B/E in T2DM patients were negatively correlated with IL-6 and hs-CRP,and positively correlated with CD4^(+)/CD8^(+);E.coli and enterococci were positively correlated with IL-6 and hs-CRP levels,and negatively correlated with CD4^(+)/CD8^(+)(P<0.05).Conclusion The imbalance of intestinal flora and impaired colonization in T2DM patients may be related to the decrease of CD4^(+)/CD8^(+)and the increase of inflammatory cytokines IL-6 and hs-CRP.