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短期胰岛素强化治疗对新诊断 2 型糖尿病患者循环 T 细胞亚群的影响。

The effect of short-term intensive insulin therapy on circulating T cell subpopulations in patients with newly diagnosed type 2 diabetes mellitus.

机构信息

Department of Endocrinology, the Affiliated Nanjing Hospital of Nanjing Medical University, Nanjing, China; Department of Endocrinology, Huai'an Second People's Hospital and the Affiliated Huai'an Hospital of Xuzhou Medical University, Huaian, Jiangsu, China.

Department of Endocrinology, the Affiliated Nanjing Hospital of Nanjing Medical University, Nanjing, China; Department of Endocrinology, Yancheng City No. 1 People's Hospital, Yancheng, Jiangsu, China.

出版信息

Diabetes Res Clin Pract. 2019 Mar;149:107-114. doi: 10.1016/j.diabres.2019.02.007. Epub 2019 Feb 10.

Abstract

AIMS

To evaluate the effect of short-term intensive insulin therapy on circulating T cell subpopulations in patients with newly diagnosed type 2 diabetes mellitus (T2DM).

METHODS

A total of 113 patients with T2DM and 28 normal subjects were enrolled. Demographic parameters and biochemical markers were collected at baseline, and flow cytometry was applied to determine the proportion of T cell subpopulations in participants. Then the patients underwent continuous subcutaneous insulin injection (CSII) treatment with euglycemia for 2 weeks, and the T cell subpopulations were measured again after CSII treatment.

RESULTS

Compared with normal subjects, the proportion of Th1 cells and the ratio of Th1/Th2 increased, the proportion of Treg cells decreased in patients with T2DM (p < 0.05 for all). The ratio of Th1/Th2 was positively correlated with glycosylated hemoglobin A1c (HbA1c) and negatively correlated with high density lipoprotein cholesterol (HDL-C). Furthermore, there were negative associations between the proportion of Treg cells and fasting plasma glucose, HbA1c, triglyceride, low density lipoprotein cholesterol, and positive association between the proportion of Treg cells and HDL-C. After CSII treatment, the proportion of Th1 cells and the ratio of Th1/Th2 decreased (p < 0.05 for both), the proportion of Treg cells increased in patients with T2DM (p < 0.05).

CONCLUSIONS

Short-term intensive insulin therapy could modulate circulating T cell subpopulations in patients with T2DM, which might alleviate inflammatory responses caused by hyperglycemia. This study was registered with ChiCTR-OPN-17010405.

摘要

目的

评估短期强化胰岛素治疗对新诊断 2 型糖尿病(T2DM)患者循环 T 细胞亚群的影响。

方法

共纳入 113 例 T2DM 患者和 28 例正常对照者。收集基线时的人口统计学参数和生化标志物,并应用流式细胞术确定参与者 T 细胞亚群的比例。然后,患者接受 2 周的胰岛素皮下输注(CSII)治疗以使血糖正常化,并在 CSII 治疗后再次测量 T 细胞亚群。

结果

与正常对照者相比,T2DM 患者的 Th1 细胞比例和 Th1/Th2 比值增加,Treg 细胞比例降低(p 值均<0.05)。Th1/Th2 比值与糖化血红蛋白 A1c(HbA1c)呈正相关,与高密度脂蛋白胆固醇(HDL-C)呈负相关。此外,Treg 细胞比例与空腹血糖、HbA1c、甘油三酯、低密度脂蛋白胆固醇呈负相关,与 HDL-C 呈正相关。CSII 治疗后,T2DM 患者的 Th1 细胞比例和 Th1/Th2 比值降低(p 值均<0.05),Treg 细胞比例增加(p 值均<0.05)。

结论

短期强化胰岛素治疗可调节 T2DM 患者的循环 T 细胞亚群,从而减轻高血糖引起的炎症反应。本研究已在 ChiCTR-OPN-17010405 注册。

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