| Objective:To observe the expression of T helper 17 cells(Th17),Regulatory T cells(Tregs),Interleukin-17(IL-17)and Transforming growth factor beta(TGF-β)in the peripheral blood of patients with type 2diabetes mellitus(T2DM)with varying degrees of chronic periodontitis(CP),and analyze the correlation between them and periodontal index.So as to explore the role of Th17/Treg imbalance in the bidirectional relationship between T2DM and CP.Methods:A total of 88 patients and healthy people were selected in May 2018 to May 2019 in the Xinjiang Uygur Autonomous Region People’s hospital,respectively as the healthy control group(groupⅠ)21 cases,case group were 67 T2DM patients with similar blood glucose control,according to the severity of periodontitis divided into pure T2DM group(groupⅡ)25 cases,T2DM with mild periodontitis(groupⅢ)22 cases and T2DM patients with moderately severe periodontitis(groupⅣ)20 cases.The clinical biochemical indexes of T2DM patients including fasting blood glucose(FPG)and glycosylated hemoglobin(HbA1c)were collected from all cases.General data such as age,gender,height and weight of all subjects were recorded,and thorough periodontal examination was conducted to collect periodontal pocket depth(PD)and bleeding index(BI).Fasting venous blood was collected in the morning and peripheral blood mononuclear cells(PBMC)were extracted from the blood cells after centrifugation.The proportion of Th17 cells and Treg cells in CD4+cells was detected by flow cytometry.And serum was separated from part of the blood for the detection of IL-17 and TGF-βlevels in serum by ELISA.SPSS24.0 was used for statistical analysis to compare the differences of demographic data,periodontal index,clinical biochemical indicators and laboratory indicators(The proportion of Th17 cells and Treg cells in CD4~+cells,the ratio of Th17/Treg,IL-17 and TGF-β)between groups.Correlation analysis was conducted between laboratory indexes and periodontal index PD and BI to analyze the relationship between them and periodontal inflammation.Results:There were no significant differences among groups with respect to age and gender(P>0.05).There were no significant statistical difference in FPG,duration of diabetes,HbA1c and other clinical biochemical indexes among the T2DM patients(P>0.05).Clinical periodontal indicators showed that PD and BI index of T2DM with mild and moderately severe CP were higher than those of healthy controls and pure T2DM group,and PD index of T2DM with moderately severe CP was higher than T2DM mild CP group,with statistically significant difference(P<0.05).The proportion of Th17 cells was the highest in T2DM patients with moderate and severe CP(1.50±0.46)%,which was significantly higher than that in the pure T2DM group(0.90±0.33)%,the mild CP group(1.06±0.45)%and the healthy control group(0.53±0.31)%(P<0.05).The proportion of Treg cells in the case group was significantly lower than that in the healthy control group,which were 3.92±1.10,3.98±1.05,3.71±1.48,4.94±1.66%(P<0.05),but there was no significant difference among the three groups(P>0.05).The ratio of Th17/Treg in the other three groups was significantly higher than that in the healthy control group(which were 0.20(0.13),0.25(0.16),0.41(0.23)vs 0.10(0.06),P<0.05),while the Th17/Treg ratio of groupⅣwas higher than that of groupⅡ.The serum IL-17 level in the T2DM group with moderate and severe CP was significantly higher than that in the pure T2DM group and the healthy control group,which were 49.77±26.01,34.03±20.25 and31.17±17.10 pg/mL respectively.While the concentration of IL-17 in T2DM with mild CP group was45.55±24.49 pg/mL,significantly higher than that in the healthy control group(P<0.05).There was no significant difference in TGF-βconcentration among the groups(which were 509.19±266.10,376.52±188.46,348.66±92.59,349.03±157.56pg/mL respectively,P>0.05).Pearson correlation analysis showed that Th17,the ratio of Th17/Treg and IL-17 were positively correlated with PD(r=0.5990,0.5199,0.3351,P<0.05),While Th17,the ratio of Th17/Treg and IL-17 were positively correlated with BI(r=0.2886,0.2962,0.2674,P<0.05).Conclusion:The proportion of Th17 cells and the ratio of Th17/Treg increased in T2DM patients with moderate and severe CP,indicating that there was Th17/Treg imbalance in them and it was inclined to Th17 cells.The proportion of Th17 cells and the concentration of IL-17 increased in T2DM patients with moderate and severe CP,indicating that Th17/IL-17 might play an important role in the occurrence and development of T2DM with CP.Th17 cells,the ratio of Th17/Treg and the concentration of IL-17 were positively correlated with PD and BI. |
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