Changes Of Peripheral Blood CD4⁺ And CD8⁺ In Elderly T2DM Patients With Different Levels Of HbA1c

ObjectiveTo study the changes of CD4⁺T cell level,CD8⁺T cell level and CD4⁺/CD8⁺T cell ratio in peripheral blood of elderly T2DM patients with different levels of HbA1c,and to explore its clinical application in elderly patients with type 2 diabetes,so as to provide a new idea for the elderly to control the degree of blood glucose.MethodFrom September 2019 to December 2021,serum samples of healthy people and diabetes inpatients and outpatients in a hospital physical examination center were collected.A total of 136 patients with diabetes in the experimental group were collected.The glycosylated hemoglobin values of the patients in the experimental group were measured.According to the high and low levels of glycosylated hemoglobin,they were divided into 5 groups,which were 4%-6%of glycosylated hemoglobin（group A）,6%-8%of glycosylated hemoglobin（group B）,and 8%-10%of glycosylated hemoglobin（Group C）,glycosylated hemoglobin>10%（Group D）and healthy control group were non diabetes patients（Group E）.T cell subsets were detected by double antibody sandwich method.CD4⁺T cell level,CD8⁺T cell level and CD4⁺/CD8⁺T cell ratio of all subjects were measured,and the obtained data were statistically analyzed.Result1.There was no significant difference in age,body mass index（BMI）,disease course,total cholesterol,albumin and leukocyte between the five groups,and there was comparability between the groups;The levels of fasting blood glucose（FPG）and glycosylated hemoglobin（HbA1c）in group A,group B,group C and group D were significantly higher than those in healthy control group（Group E）（P<0.01）.2.CD4⁺%in group A,group B,group C and group D were significantly lower than that in Group E of healthy control group（P<0.01）,and the difference was statistically significant.With the increase of glycosylated hemoglobin in group A-D,CD4⁺%further decreased.3.The CD8⁺%of group A,group B,group C and group D were higher than that of group E of healthy control group（P<0.01）.The difference was statistically significant.Moreover,according to the experimental results,when the glycosylated hemoglobin of patients in group A-D increased,the CD8⁺%further increased.4.CD4⁺/CD8⁺in group A,group B,group C and group D were lower than those in Group E of healthy control group（P<0.01）.The difference was statistically significant.With the increase of glycosylated hemoglobin in group A-D,CD4⁺/CD8⁺further decreased.5.Comparison of CD4⁺%among all groups:Compared with the CD4⁺%of group A and group C,P was 0.026,P<0.05;Compared with the CD4⁺%of group D,P<0.01.Compared with the CD4⁺%of group B and group D,P was 0.002,P<0.05;Compared with the CD4⁺%of group E,P was 0.036,P<0.05.The CD4⁺%of group D was compared with that of group E,P<0.01.6.Comparison of CD8⁺%among groups:Compared with CD8⁺%in group A and group D,P<0.01;Compared with CD8⁺%in group E,P<0.01.CD8⁺%in group B was compared with CD8⁺%in group D,P<0.01;And compared with CD8⁺%in group E,P<0.01.CD8⁺%in group C was compared with that in group E,P<0.01.CD8⁺%of group D was compared with group E,P<0.01.7.Comparison of CD4⁺/CD8⁺among groups:Group A compared with group D,P<0.05.The CD4⁺/CD8⁺of group B was compared with that of group D,P<0.01;The CD4⁺/CD8⁺of group B was compared with that of group E,P<0.01.The ratio of CD4⁺/CD8⁺in group C was statistically significant compared with that in group E,P<0.01.The difference of CD4⁺/CD8⁺in group D was statistically significant compared with that in group E,P<0.01.Conclusion1.CD4⁺T cells and CD4⁺T cell/CD8⁺T cell ratio in peripheral blood of patients with type 2 diabetes mellitus were lower in healthy control group,while CD8⁺T cell ratio was higher in healthy control group,suggesting that cellular immunity may be related to type 2 diabetes mellitus.2.The levels of CD4⁺T cells,CD8⁺T cells and the ratio of CD4⁺T to CD8⁺T cells in peripheral blood of 166 elderly T2DM patients with different HbA1c levels were measured.It was observed that the higher HbA1c level in elderly T2DM patients,the worse the immune ability of patients.There is a significant correlation between the control degree of HbA1c and the patient’s immunity.3.The CD4⁺%,CD8⁺%and CD4⁺/CD8⁺in group A,group B,group C and group D of elderly patients with type 2 diabetes were significantly different from those in Group E of healthy control group,indicating that the immunity of patients with type 2diabetes was significantly weaker than that of normal people.In the pairwise comparison between groups,it can be found that the elderly patients with type 2diabetes have little impact on their immune ability when the glycosylated hemoglobin is controlled within the range of 4%-8%.With the increase of glycosylated hemoglobin,when glycosylated hemoglobin is 8%-10%,the immune function of the body further decreases.When HbA1c>10%,the patients in the experimental group found that their immunity decreased significantly.Therefore,it can be concluded that the lower the glycated hemoglobin in the elderly patients with type 2 diabetes is not the better.The glycated hemoglobin in the elderly patients with type 2 diabetes can be controlled below 8%.At this time,the impact on the immunity of the elderly patients is relatively small.This experimental conclusion provides a new idea for the degree of blood glucose control in the elderly patients with type 2 diabetes.