The Expression Of CD4~+CD25~+Foxp3~+ Treg And The Level Of Related Cytokine (IL-10,TGF-β) In The Newly Diagnosed Type 2 Diabetic Patients

Objective:To investigate the frequence of CD4+CD25+Foxp3+Treg and the level of related cytokine (IL-10,TGF-β) in the newly diagnosed type 2 diabetes and the relationship between the CD4+CD25+Foxp3+Treg and insulin resistance, blood lipid, IL-10,TGF-β.Methods:From September 2009 to December 2010, We selected 51 newly diagnosed type 2 diabetes, who were diagnosed less than 1 year, in our hospital including 37 males and 14 females,46.24±10.22 years old. They must fit the following standard:(1) the diagnose and typing standard made in 1999 by WHO; (2) all the objects didn't have acute or chronic infections, cancer, autoimmune disease and other chronic or acute complications of diabetes mellitus; (3) hadn't taken immuno-suppressive agents, aspirin, lipid-lowering drugs, and any hypoglycemic agents (including insulin) one month before hospitalization. Body height and weight were measured in all of the selected objects and then we calculated the body mass index (BMI). All subjects were fasted for more than 8 hours, and then were got the venous blood at the next morning. We separated the serum and the fasting glucose (FPG), fasting insulin(FINS), triglyceride(TG), total cholesterol(TC), glycosylated hemoglobin(HbAlc) were tested. At the same time,4-6ml of blood were taken with EDTA anticoagulant tubes to detect the frequence of the CD4+CD25+Foxp3+Treg by flow cytometry; then 2-4ml serum were taken to test the level of IL-10 and TGF-β.The serum levels of IL-10 and TGF-βwere assayed by enzyme-linked immunosorbent assay kits; insulin resistance index was calculated by homeostasis model. According to the body mass index, the patients were divided into two groups:the non-obese group and the obese group. we chose 55 heathy medical workers in our hospital as control group whose body mass index are in the normal range, including 40 males and 15 females,49.63±7.35years old.Results:(1) The percentage of CD4+CD25+Foxp3+Treg of the newly diagnosed T2DM group is significantly reduced than the control group (P<0.01), the levels of IL-10 and TGF-βare also reduced than the control group (P<0.05);(2) The percentage of CD4+CD25+Foxp3+Treg and the leve of IL-10 in the obese group of the newly diagnosed T2DM group are reduced than the non-obses group. (P<0.05)(3) In obese T2DM group, the percentage of Treg was negatively correlated with HOMA-IR and was positive correlated with TGF-β(P<0.05).Conclusion:(1) The percentage of CD4+CD25+Foxp3+Treg and the level of related cytokine (IL-10,TGF-β) in the newly diagnosed type 2 diabetic patients were precipitously decreased. Therefore, the newly diagnosed T2DM patients may suffer autoimmune regulatory disfunction and the deficiency of TGF-βmay play an important role in the process.(2) In obese T2DM group, the percentage of Treg is negatively correlated with HOMA-IR. Increasing the expression of Treg may improve the IR in newly diagnosed type 2 diabetes patients with obesity.(3) What we've done is started curing diabetes from inflammation and damage mechanism of immune. Strengthening the expression of treg maybe a good idea of curing the T2DM.