Effects Of S1P And CD69 On Pathogenesis Of Patients With Type 2 Diabetes Complicated With Coronary Heart Disease (CHD)

Purpose:The goal of our present study is to explore the possible related factors affecting the pathogenesis in type 2 diabetes mellitus patients with coronary heart disease, especially to evaluate the associations of Sphingosine-1-phosphate(S1P) concentrations and expression of CD69 on CD3+CD4+T lymphocytes(CD3+CD4+CD69+T cells) with risk of development of type 2 diabetes mellitus complicated with coronary heart disease.Methods:We collected 68 patients with type 2 diabetes complicated with coronary heart disease from October 2013 to June 2014 consecutively, during the same period,81 patients with previously confirmed diagnosis of type 2 diabetes but without coronary heart disease were collected as the control group. Enzyme-linked immunosorbent assay (ELISA) kits were used for plasma S1P, and the expression of CD69 on peripheral blood T-lymphocytes which has been stimulated 20 hours by phytagglutinin(PHA) was detected with immunofluorescence staining and flow cytometry technique.At the same time, biochemical parameters and clinical information, including high-sensitivity c-reactive protein (hsCRP), various blood sugar, several serum lipid indexes and weight,were collected.Results:The levels of plasma SIP, high density lipoprotein (HDL) and ApoAl were significantly higher in T2DM subjects than those of patients in the T2DM-CHD group (P<0.01),while CD69 expression on the CD3+CD4+T cell subpopulations after the stimulation of PHA in simple type 2 diabetics were apparently decreased compared with controls (P<0.01).In pure type 2 diabetic patients, inflammatory marker such as high sensitivity C reactive protein(hsCRP), all kinds of plasma lipidic and glycemic indexes including fasting plasma glucose (FPG), postprandial 2 h plasma glucose (2hPG), HbAle, total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL), ApoB, LP (a) and the medical history of coronary heart disease were all markedly lower when compared with that in T2DM-CHD patients (P<0.05). Logistic regression analysis showed that serum SIP level was independent protective factor of CHD in type 2diabetes,while CD69 antigen,hsCRP,2hPQLDL,Lp(a) are all separate risk factors.Conclusions:In patients with type 2 diabetes, decline of SIP level and increase of immune inflammation related indicators as CD3+CD4+CD69+T cell antigen expression and hsCRP are strong forces to enhance risk of diabetic coronary heart disease (CHD), and have close correlation with its development,which included the possibility that these changes were also involved in its etiology.