Study On The Correlation Between Fat Factor Cartonectin And The Abnormal Immune Regulation Of Newly Diagnosed Type 2 Diabetic Patients

ObjectiveIt is to discuss Cartonectin level in the serum and the expression rate of the peripheral blood CD4~+CD25~+Foxp3~+Treg,analyze the relationship between the change of Cartonectin and CD4~+CD25~+Foxp3~+Treg,Th17,and analyze the relationship between Cartonectin and IL-6,IR,fasting blood glucose(FPG),fasting insulin(FINS),triglyceride(TG),total cholesterol(TC),glycosylated hemoglobin(HbA1c),and high density lipoprotein cholesterol(HDL-C).Method90 newly diagnosed diabetic patients are selected from patients(T2DM group)in department of endocrinology from Liaocheng People's Hospital from January 2016 to October 2016,including 40 females,and 50 males who are aged of 30-60 years old.Inclusion criteria:(1)diabetes diagnosis meets the criteria of diagnosis and classification of WHO1999 diabetes.(2)For the newly diagnosed T2DM patients,the time from the diagnosis of diabetes to the treatment is less than 1 year.Before treatment this time or a definite diagnosis they never take any antidiabetic drugs,lipid-lowering drugs,or immunosuppressive agents except for acute and chronic complications of diabetes,patients with hypertension complicated with heart,liver,renal insufficiency,and patients with all kinds of acute and chronic infections,autoimmune diseases,malignant tumor diseases.According to body mass index,BMI?24kg/m~2 is taken as segmentation and the newly diagnosed T2DM group is divided into normal weight(NW)and super quality(OB)group.At the same time 40 cases of gender matched healthy volunteers are selected from physical examination center of our hospital as a control group(NGT),including 20 males and 20females who are aged of 30-50 years old,and their BMI are all in normal range.For the T2DM group,the measurement of height,weight,body mass index(BMI)is done and fasting is for 8 hours.the next morning fasting venous blood is taken and serum is separated to measure fasting blood glucose(FPG),fasting insulin(FINS),triglyceride(TG),total cholesterol(TC),glycosylated hemoglobin(HbA1c),and high density lipoprotein cholesterol(HDL-C).At the same time the 4-6ml whole blood is extracted by coagulation tube to detect the level of the Cartonectin,IL-6,FINS by ELISA.The 4-6ml whole blood is extracted by heparin anticoagulant tube to detect the percentage of CD4~+CD25~+Foxp3~+Treg?Th17 by flow cytometry.According to the FPG and FINS measured,insulin resistance index(HOMA-IR)is calculated by homeostasis model(HOMA-model).For the normal control group,the 4-6ml whole blood is extracted by coagulation tube to detect the level of the Cartonectin,IL-6 by ELISA.At the same time,the 4-6ml whole blood is extracted by heparin anticoagulant tube to detect the percentage of CD4~+CD25~+Foxp3~+Treg?Th17 by flow cytometry.All the data are inputted into the computer.By using SPSS19.0 statistical software,for comparison between the two groups of the normal distribution,two independent samples t test is taken;for non-normal distribution data,it is to convert it to normal and analyze;for those that cannot be converted into normal,it is to do non-parametric test.Analysis of variance is used to compare between groups,the correlation between Cartonectin and other indexes is analyzed by using single factor correlation analysis and partial correlation analysis,and Cartonectin multivariate analysis is taken by multiple stepwise regression analysis.Result(1)The level of serum Cartonectin of T2DM group decreases compared with that of group NGT(P<0.05),and the level of serum Cartonectin of T2DM group decreases compared with that of group T2DM-NW(P<0.05).It decreases significantly compared with the NGT group(P<0.01)(2)FPG,HbA1c,FINS,HOMA-IR,TG,IL-6 of T2DM group are significantly higher than those of group NGT(P<0.05),and the difference of BMI,TC,HDL-C between the two groups is not statistically significant(P>0.05);,HOMA-IR,FINS,TG,IL-6 of group T2DM-OB are higher than those of T2DM-NW group.(3)The serum levels of Cartonectin are negatively correlated with FPG,FINS,HOMA-IR,TG,IL-6,HbA1c(P<0.05),positive correlated with HDL-C(P<0.05),and have no significant correlation with BMI,TC.The serum levels of IL-6 are negatively correlated with CD4~+CD25~+Foxp3~+Treg cell(P<0.05),positive correlated with Th17 cell(P<0.05),and have no significant correlation with HOMA-IR,HbA1c.(4)The percentage of CD4~+T lymphocytes compared by peripheral blood CD4~+CD25~+Foxp3~+Treg cell for T2DM group decreases significantly compared with that of NGT group.Compared with the T2DM-NW group,the expression rate of CD4~+CD25~+=Treg cells for T2DM-OB group decreases significantly(P<0.05).(5)The percentage of CD4~+T lymphocytes compared by peripheral blood Th17 cell for T2DM group increases significantly compared with that of NGT group.And compared with the T2DM-NW group,the expression rate of Th17 cell for T2DM-OB group increases significantly,and the differences are statistically significant(P<0.05)(6)Compared with NGT group,proportion of Th17/Treg for T2DM group increases significantly(P<0.05).Compared with T2DM-NW group,proportion of Th17/Treg forT2DM-OB group increases significantly(7)Logistic regression analysis:HOMA-IR,HbA1c,TG are independent factors of Cartonectin.ConclusionType 2 diabetes have cellular immune dysfunction,and fat factor of Cartonectin has the role of anti-inflammatory,increasing insulin sensitivity to inhibit the activation of inflammatory cytokines to do regulation of helper T cells and balance regulatory T cells,achieving the ultimate goal of immunotherapy.Therefore,paying attention to detection of cellular immune function in patients with diabetes,has an important significance to assess the disease and do diagnosis for clinicians.