Yang Min, Du Changji, Wang Yinping, Liu Jun
Department of Endocrinology, The Fifth People's Hospital of Shanghai, Fudan University, Shanghai 200240, P.R. China.
Department of Clinical Lab, The Daopei Hospital of Shanghai, Shanghai 200240, P.R. China.
Mol Med Rep. 2017 Jun;15(6):4338-4345. doi: 10.3892/mmr.2017.6507. Epub 2017 Apr 25.
Hashimoto's thyroiditis (HT) is characterized by dysregulated immune responses and is commonly associated with insulin resistance. However, the mechanism of insulin resistance in HT remains to be fully elucidated. The aim of the present study was to investigate the correlation between the percentage of B regulatory lymphocytes (Bregs) and insulin resistance in patients with HT but with normal thyroid function (type I). A total of 59 patients with type I HT and 38 healthy volunteers were enrolled in the study. An oral glucose tolerance test was performed to measure insulin secretion and assess β‑cell functions. Flow cytometry was performed to examine the percentages of lymphocyte populations. The patients with HT exhibited normal fasting and postprandial glucose and fasting insulin secretion, but increased secretion of early‑phase and total insulin. The patients with HT also had insufficient β‑cell compensation for insulin resistance, indicated by a reduced disposition index, in the fasting state. An elevation in the percentage of CD19+CD24+CD27+ Bregs was also observed, which correlated positively with insulin secretion and insulin resistance in the fasting state. The patients with type I HT had postprandial insulin resistance and insufficient β‑cell compensation for fasting insulin resistance. Therefore, the increase in CD19+CD24+CD27+ Bregs was closely associated with fasting insulin secretion. These results provide novel insight into the mechanism of insulin resistance in HT.
桥本甲状腺炎（HT）的特征是免疫反应失调，且通常与胰岛素抵抗相关。然而，HT中胰岛素抵抗的机制仍有待充分阐明。本研究的目的是调查甲状腺功能正常的HT患者（I型）中B调节淋巴细胞（Bregs）百分比与胰岛素抵抗之间的相关性。共有59例I型HT患者和38名健康志愿者纳入本研究。进行口服葡萄糖耐量试验以测量胰岛素分泌并评估β细胞功能。采用流式细胞术检测淋巴细胞亚群的百分比。HT患者空腹和餐后血糖及空腹胰岛素分泌正常，但早期和总胰岛素分泌增加。HT患者在空腹状态下也存在β细胞对胰岛素抵抗的代偿不足，表现为处置指数降低。还观察到CD19+CD24+CD27+Bregs百分比升高，且与空腹状态下的胰岛素分泌和胰岛素抵抗呈正相关。I型HT患者存在餐后胰岛素抵抗以及β细胞对空腹胰岛素抵抗的代偿不足。因此，CD19+CD24+CD27+Bregs增加与空腹胰岛素分泌密切相关。这些结果为HT中胰岛素抵抗的机制提供了新的见解。
