Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, China.
School of Management, Shanxi Medical University, Taiyuan, China.
Front Immunol. 2024 Oct 4;15:1445639. doi: 10.3389/fimmu.2024.1445639. eCollection 2024.
In patients with rheumatoid arthritis (RA), the increased risk of concomitant type 2 diabetes mellitus (T2D) is an important contributor to increased mortality and decreased quality of life; however, the mechanisms and pathogenetic factors remain unknown.
In this study, we aimed to assess the risk factors for T2D in patients with RA. We recruited 206 healthy controls and 488 patients with RA, 160 of whom had comorbid T2D. General clinical information, disease characteristics, and circulating lymphocyte levels detected using modified flow cytometry were collected from all participants. Logistic regression models adjusted for confounders were fitted to estimate the risk factors of T2D in patients with RA.
The incidence of RA in patients with T2D was 15.6%. Patients with RA and T2D had a longer disease duration, higher BMI, and a higher incidence of hypertension and a family history of diabetes than those with RA but no T2D. The absolute numbers of T helper 2 cell (Th2) and Regulatory T cells (Treg) decreased in patients with RA and T2D, which led to an increase in the ratios of Th1/Th2 and Th17/Treg cells. Multivariate logistic regression analysis showed that a family history of diabetes, a higher incidence of hypertension, higher neutrophil-lymphocyte ratio (NLR) levels, lower platelet-lymphocyte ratio (PLR) levels, and fewer circulating Th2 and Treg cells were associated with an increased risk of T2D in patients with RA.
The levels of peripheral lymphocytes, especially Th2 and Treg cells, are closely related to the occurrence of T2D in patients with RA; however, the influence of body mass index (BMI), family history of diabetes, and systemic inflammation should not be ignored.
在类风湿关节炎（RA）患者中，2 型糖尿病（T2D）的并发风险是导致死亡率增加和生活质量下降的重要因素；然而，其机制和发病因素仍不清楚。
在这项研究中，我们旨在评估 RA 患者发生 T2D 的风险因素。我们招募了 206 名健康对照者和 488 名 RA 患者，其中 160 名患有合并 T2D。从所有参与者中收集了一般临床信息、疾病特征和使用改良流式细胞术检测的循环淋巴细胞水平。拟合了经混杂因素调整的逻辑回归模型，以评估 RA 患者发生 T2D 的风险因素。
T2D 患者中 RA 的发生率为 15.6%。与仅患有 RA 者相比，同时患有 RA 和 T2D 的患者具有更长的疾病病程、更高的 BMI、更高的高血压发生率和糖尿病家族史。RA 和 T2D 患者的辅助性 T 细胞 2（Th2）和调节性 T 细胞（Treg）的绝对数量减少，导致 Th1/Th2 和 Th17/Treg 细胞的比值增加。多变量逻辑回归分析显示，糖尿病家族史、高血压发生率较高、中性粒细胞与淋巴细胞比值（NLR）水平较高、血小板与淋巴细胞比值（PLR）水平较低以及循环 Th2 和 Treg 细胞数量较少与 RA 患者发生 T2D 的风险增加相关。
外周淋巴细胞水平，尤其是 Th2 和 Treg 细胞，与 RA 患者 T2D 的发生密切相关；然而，不应忽视体重指数（BMI）、糖尿病家族史和全身炎症的影响。
