| It has been unclear what is the pathogenesis of type 2 diabetes, although it is well established that insulin resistance and impaired insulin secretion are central to the pathogenesis of type 2 diabetes.There is increasing evidence that chronic low-grade inflammation and activation of the innate immune system are closely involved in the pathogenesis of type 2 diabetes. Diabetic macrovascular complications ,account for disabilities and high mortality rates in patients with type 2 Diabetes, include the thickening of intima-media and the formation of arteriosclerosis. Recent data showed that macrovascular disease was also chronic inflammation disease. T lymphocyte subsets were the most important subset of cellular immunity.The imbalance of CD4+T cells and CD8+T cells , high frequency of special T lymphocyte subsets , were both related to the development and progression of autoimmune disease. CD4+CD28-T cells exhibit autoreactivity and are resistant to apoptosis. CD4+CD25+ T cells have properties of immune nullipotency and immunosuppression, they do not produce IL-2 and are anergic following antigen-induced activation ,can inhibit CD4+ and CD8+T cells proliferation and cytokine production. We analyzed the changes of T lymphocyte subsets,with an emphasis on CD4+CD28-T cells and CD4+CD25+ T cells,to determine their roles in type 2 Diabetes and its macrovascular complications.Objective :To investigate the changes of T lymphocyte subsets in periphera1 blood and their roles in the development of type 2 Diabetes and its macrovascular complications.Methods :Immunofluorescence staining and flow cytometry method were used to detect the expression of CD3,CD4,CD8 on T lymphocyte subsets in periphera1 blood and the changes of CD4+CD28-T cells,CD4+CD25+T cells,which from 36 T2DM alone,30 T2DM with macrovascular complications(the common carotid artery had plaque which were measured by high resolution ultrasound) and 20 health controls. Data were dealt with statistics analysis.Results :1.In T2DM with macrovascular disease and T2DM alone, the percentage of CD4+T cells(45.82±2.68%,39.93±5.41%) were higher than that in health controls(30.57±3.59%)(P<0.05),CD4+T cells/CD8+T cells(2.39±0.12,1.75±0.32) were lower than that in health controls(1.34±0.25 )(P<0.05), the percentage of CD3+T cells (58.8±9.1%,60.73±5.18%)were lower than that in health controls(71.07±4.81%) (P<0.05), the percentage of CD8+T cells(18.02±2.36%,21.1±2.42%) were lower than that in health controls(26.7±4.80%) (P<0.05);The percentage of CD4+T cells,CD4+T cells/CD8+T cells were higher while CD3+T cells,CD8+T cells were lower in T2DM with macrovascular disease than those in T2DM alone.2. The percentage of CD4+CD28-T cells in T2DM with macrovascular disease(13.19±5.05%) were higher than that in T2DM alone(8.47±1.80%)(P<0.05), the CD4+CD28-T cells in the two groups were markedly increased than those in control group (2.02±0.72% )(P<0.05).3. The percentage of CD4+CD25+T cells in T2DM with macrovascular disease (6.05±1.06%)were lower than that in T2DM alone(8.80±3.60%), and had significantly difference from those in control group(12.40±1.50%)(P<0.05)Conclusion :1. The imbalance of T lymphocyte subsets exist in T2DM patients.It is more serious in T2DM with macrovascular disease .These observations suggest that cellular immunity dysfunction exert certain effect on the pathogenesis and progression of type 2 diabetes mellitus and its macrovascular disease.2. The number of CD4+CD28-T cells were increased and CD4+CD25+T cells were decreased in T2DM , which were obvious in T2DM with macrovascular disease .It has been indicated that both CD4+CD28-T cells and CD4+CD25+T cells may closely correlate with the etiology and development of type 2 diabetes mellitus and its macrovascular disease.
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