The Observational Study About Imbalance Of T Helper Cell 17(Th17) And Regulatory T Cell(Treg) In The Development Of HOMA-IR、HOMA-β In Type 2 Diabetes Mellitus

Objective:In order to investigate the role of adaptive immunity in the development of type 2diabetes mellitus(T2DM),peripheral blood CD4~+T cell subsets were detected in patients with type 2 diabetes mellitus(T2DM)and healthy subjects.Methods:35 patients with type 2 diabetes diagnosed and treated in the department of endocrinology of the second hospital of shanxi medical university from October 2016 to May 2018(who met the WHO1999 criteria)were selected as the diabetes mellitus group(T2DM group),and 30 healthy subjects with age and weight matching in the physical examination center of our hospital were selected as the control group(NC group).General data were collected and biochemical detection,fasting insulin,glycosylated hemoglobin(HbA1c)and CD4~+T cell subsets were analyzed.Insulin resistance index(HOMA-IR)and pancreatic islet function(HOMA-β)were calculated,and the correlation between CD4~+T cell subsets and insulin resistance index and pancreatic islet function was analyzed.Results:1.Comparison between the general data groups:there was no significant difference in gender or age between the two groups(P>0.05);Compared with the NC group,BMI, HbA1c,HOMA-IR,Treg in the T2DM group were higher than those in the control group,with statistically significant differences(P<0.05,P<0.01),decreased homa-βwith statistically significant differences(P<0.05).2.Comparison of serum levels of Th1,Treg,Th17 and their ratios between groups: compared with NC group,serum levels of Th1,Th17 and Th17/Treg in T2DM group were significantly increased(P<0.05).Serum Treg cell level was significantly decreased(P<0.05).3.Correlation analysis showed that Th1,Th17,Th17/Treg cells,HbA1c and BMI were positively correlated with homa-IR,while Treg cells were negatively correlated with HOMA-IR(P<0.05).Th1,Th17,Th17/Treg cells were significantly negatively correlated with HOMA-β,while Treg cells were significantly positively correlated with HOMA-β(P<0.05).Multiple linear regression showed that Th1,Th17,Th17/Treg,HbA1c,and BMI were independent risk factors for insulin resistance,and Th1,Th17,Th17/Tregnd aislet beta cell function were independent risk factors(P<0.05).Conclusion:1.The levels of Th1 and Th17 cells and Th17/Treg ratio in peripheral blood of type 2 diabetes patients were significantly higher than those of non-type 2 diabetes patients, and the levels of Treg cells were significantly lower,suggesting that the CD4~+T cell subsets in type 2 diabetes patients were out of balance,and CD4~+T cell subsets were closely related to T2DM.2.Th1,Th17,Treg cell levels and Th17/Treg ratio are correlated with insulin resistance and secretion function damage of islet cells,which are independent factors affecting the development of T2DM.This suggests that CD4~+T cell subsets are out of balance in the two core pathological processes of T2DM,and may be a new method for the treatment of T2DM.