2型糖尿病合并骨质疏松患者短链脂肪酸、细胞免疫和炎症因子的变化

Changes of Short-chain Fatty Acids,Cellular Immunity and Inflammatory Factors in Patients with Type 2 Diabetes Mellitus Combined with Osteoporosis

目的探讨2型糖尿病(diabetes mellitus type 2,T2DM)患者短链脂肪酸(short chain fatty acids,SCFAs)、细胞免疫和炎症因子的变化。方法选取2020年3月—2022年6月杭州师范大学附属医院收治的T2DM患者60例,根据随访结果分为两组,2型糖尿病伴骨质疏松作为观察组,2型糖尿病不伴骨质疏松作为对照组,各30例。检测两组患者SCFAs、CD4^(+)T细胞、CD8^(+)T细胞、白介素-6(interleukin-6,IL-6)和肿瘤坏死因子(tumor necrosis factor-α,TNF-α),测定患者L_(2~4)及左股骨颈的骨密度(bone mineral density,BMD),比较两组上述各检测指标差异。结果观察组乙酸、丙酸、丁酸、己酸和异己酸均低于对照组,差异有统计学意义(P<0.05)。观察组CD4^(+)T细胞低于对照组,CD8^(+)T细胞、IL-6和TNF-α高于对照组,差异有统计学意义(P<0.05)。结论2型糖尿病患者短链脂肪酸、细胞免疫和炎症因子发生改变,可能对糖尿病性骨质疏松产生影响。

Objective To investigate the changes of short-chain fatty acids(SCFAs),cellular immunity and inflamma-tory factors in diabetes mellitus type 2(T2DM)patients.Methods A total of sixty T2DM patients admitted to the Affili-ated Hospital of Hangzhou Normal University from March 2020 to June 2022 were selected and divided into two groups according to the follow-up results:T2DM with osteoporosis as the observation group and T2DM without osteo-porosis as the control group,with thirty cases each.SCFAs,CD4^(+)T cells,CD8^(+)T cells,interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)were detected in both groups.The bone mineral density(BMD)of the patients'L_(2~4)and left femoral neck were measured,and the differences of the above indexes were compared between the two groups.Results Acetic acid,propionic acid,butyric acid,caproic acid and isocaproic acid in observation group were lower than those in control group,and the differences were statistically significant(P<0.05).CD4^(+)T cells in the observation group were lower than those in the control group,and CD8^(+)T cells,IL-6 and TNF-αwere higher than those in the control group,and the difference was statistically significant(P<0.05).Conclusion Changes in short-chain fatty acids,cellular immunity and inflammatory factors in patients with type 2 diabetes may influence diabetic osteoporosis.