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目的观察血清总同型半胱氨酸(total homocysteine,t Hcy)、叶酸水平及外周血T淋巴细胞亚群在2型糖尿病(type 2dibaetes mellitus,T2DM)患者中的变化,探讨t Hcy、叶酸与T2DM细胞免疫间的关联性。方法 2014年7月—2015年4月采用流式细胞术和化学发光免疫分析技术分别检测74例单纯T2DM、44例糖尿病肾病(diabetic nephopathy,DN)患者及124例健康对照血清中t Hcy、叶酸水平和外周血T淋巴细胞亚群变化。计量资料比较采用t检验,计数资料比较采用χ2检验,数据间关联性分析采用Pearson相关分析,P<0.05为差异有统计学意义。结果 T2DM组与对照组患者叶酸、t Hcy、CD3+细胞、CD3+CD4+细胞、CD3+CD8+细胞比较,差异均有统计学意义(t=13.152、8.305、13.052、15.814、8.524,均P<0.05);单纯T2DM组与糖尿病肾病(diabetic nephropathy,DN)组患者的叶酸、t Hcy、CD3+细胞、CD3+CD4+细胞、CD3+CD8+细胞比较,差异均有统计学意义(t=4.494、4.326、3.765、6.750、5.459,均P<0.05)。血清t Hcy水平与叶酸水平、CD3+细胞、CD3+CD8+细胞呈负相关(r=-0.300、-0.116、-0.130,均P<0.05),与CD3+CD4+正相关(r=0.267,P<0.05)。血清叶酸水平与CD3+CD4+细胞呈负相关(r=-0.108,P<0.05)。结论高t Hcy可能通过T细胞介导的免疫损伤在T2DM的发生发展中起作用,叶酸也会对T2DM的细胞免疫产生影响。
Objective To observe the changes of serum total homocysteine (t Hcy), folic acid and peripheral blood T lymphocyte subsets in type 2 diabetic patients with type 2 diabetes mellitus (T2DM) Correlation between cellular immunity. Methods From July 2014 to April 2015, flow cytometry and chemiluminescence immunoassay were used to detect the levels of t-Hcy, folate in 74 patients with T2DM alone, 44 patients with diabetic nephropathy (DN) and 124 healthy controls Levels and Peripheral Blood T Lymphocyte Subsets. Measurement data were compared using t test, count data were compared using χ2 test, the correlation between the data using Pearson correlation analysis, P <0.05 for the difference was statistically significant. Results There were significant differences in the levels of folate, t Hcy, CD3 + cells, CD3 + CD4 + cells and CD3 + CD8 + cells between T2DM group and control group (t = 13.152,8.305,13.052,15.814,8.524, all P <0.05) ; The levels of folate, t Hcy, CD3 + cells, CD3 + CD4 + cells and CD3 + CD8 + cells in T2DM group and diabetic nephropathy group were significantly different (t = 4.494, 4.326, 3.765, 6.750,5.459, all P <0.05). Serum t Hcy levels were negatively correlated with folic acid levels, CD3 + cells and CD3 + CD8 + cells (r = -0.300, -0.116, -0.130, all P <0.05) ). Serum folic acid levels were negatively correlated with CD3 + CD4 + cells (r = -0.108, P <0.05). Conclusion High t Hcy may play a role in the development of T2DM through T cell mediated immune injury. Folic acid may also affect the cellular immunity of T2DM.