| Diabetic Microangiopathy is one of the main chronic complications of diabetes mellitus and immunologic mechanism probably participates in its pathogenesis. And patients with diabetes are liable to complicate with infections, which may be relevant to the changes of T lymphocyte subsets and cellular immune dysfunction. According to surface mark, T lymphocytes are subdivided into CD4+ and CD8+ T cell subsets. They have important role both in recognizing and combining antigen and signal transportation. T lymphocyte subpopulations take part in the process of diabetic microangiopathy and infection by releasing cytokines. The dysfunction of T lymphocytes and NK cells and inbalance of cytokines may be the risks for diabetic microangiopathy and infections. The present study is to investigate the levels of T lymphocyte subsets and NK cells in peripheral blood by flow cytometry monoclonal immunofluorescence and evaluate the relationship between the changes of T lymphocyte subsets and NK cell and the risks for microangiopathy and infections in patients with type 2 diabetes.Part I (Infection)MethodsA total of 60 type 2 diabetic patients and 30 normal controls (group 1,G1) were studied. All type 2 diabetic patients were divided into 2 groups according to infections: group 2 (G2, n=30): patients without infections; group 3 (G3, n=30): patients complicated with infections including 11 patients with respiratory tract infections, 6 with urinary tract infections, 6 with skin infections, 4 with infections of biliary tract, and 3 with enteritis, periappendiceal abscess and epididymitis respectively.T lymphocyte subsets and NK cell levels were measured by flow cytometrymonoclonal immunofluorescence . The results were expressed as mean ± standard deviation. T-test and one-way analysis of variance of biological data were performed. Multiple comparison was accomplished by Student-Newman-Keuls method. All statistic tasks were accomplished with the software of SPSS 11.5. Results1. The levels of fasting plasma glucose (FPG) in G2 (9.01±3.11mmol/L) and G3 (8.63±2.61mmol/L) were significantly higher than that in G1 (4.85±0.42mmol/L, P<0.01). There were no significant difference in duration, FPG, HbA1c and C-peptide levels between G2 and G3. There were no significant difference in age, body mass index(BMI), triglyceride(TG), totol cholesterol(TC), systolic blood pressure(SBP) and diastolic blood pressure(DBP) among the three groups.2. In type 2 diabetic patients, the levels of CD3 (56.45±13.27), CD4+ (31.19±8.34) and NK(15.12± 7.05) cells were significantly lower than those in Gl (65.81±6.54, 35.33±5.78, 22.40±8.13, respectively, P<0.05).3. The levels of CD3 (51.60±13.79), CD4+ (29.07±9.12), CD8+ (21.40±9.04) and NK(15.10±7.44) cells in G3 were significantly lower than those in Gl (P<0.01); NK cells (15.13±6.76) in G2 was lower than that in G1 (P<0.01); The levels of CD3,CD4+ and CD8+ T lymphocyte subsets in G3 were significantly lower than those in G2 (61.31±10.93, 33.32±7.00, 26.18±6.62, respectively, P<0.05). There was no significant difference in NK cells levels between G2 and G3.There was no significant difference in CD4+/CD8+ among the three groups.4. Correlation analysis: there were positive correlation between the levels of CD8+ T cell and TC (r=0.430, P=0.018) and negtive correlation between CD4+/CD8+ and TC (r=-0.434, P=0.017) in all of the type 2 diabetic patients and the diabetic patients complicated with infections.There was positive correlation between NKcell level and SBP in G3 (r=0.569, P=0.001). No correlation was found in T lymphocytes and NK cells with FPG, TG, TC, SBP, DBP in G1.Part II (Microangiopathy)MethodsA total of 60 type 2 diabetic patients and 30 normal controls (group, G1) were studied. All type 2 diabetic patients were divided into 2 groups according to urinary albumin excretion rate (UAER) and funduscope examination: group 4 (G4): patients without microangiopathy ( UAER<30mg/24h and no diabetic retinopathy); group 5 (G5)...
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