Acta Academiae Medicinae Sinica

Abstract: Objective To explore the relationship between the T cell subsets and glucose level and first-phase insulin secretion function in patients with type 2 diabetes mellitus (T2DM). Methods We determined the oral glucose tolerance (OGTT), insulin release test(IRT), body mass index(BMI), glycohemoglobin A1c (HbA1c), T lymphocyte subsets （CD4⁺,CD8⁺）, and activity of natural kill(NK) cell and ⊿I₃₀/⊿G₃₀ in 78 newly diagnosed T2DM patients, 60 impaired glucose tolerance (IGT) patients, and 60 normal controls. Results DM and IGT patients had significantly lower levels of CD4⁺, CD4⁺/CD8⁺ratio, activity of NK cell, and ⊿I₃₀/⊿G₃₀ and significantly higher levels of HbA1c and CD8⁺compared with normal controls（all P＜0.05）. Patients in DM group had significantly lower level of CD4⁺,⊿I₃₀/⊿G₃₀ and significantly higher levels of FBG and HbA1c compared with IGT group. There was no significant difference in terms of CD8⁺, CD4⁺/CD8⁺ratio, and activity of NK cell between IGT and DM groups, whereas CD4⁺ T cells were negatively correlated with FBG and HbA1c and positively with ⊿I₃₀/⊿G₃₀ . Multipul regression stepwise analysis showed that CD4⁺ was independently associated with HbA1c and ⊿I₃₀/⊿G₃₀. Conclusion T2DM patients tends to have disorders in cellular immunity, which is correlated with blood glucose level and the insulin secretion function.

Key words: type 2 diabetes mellitus, T lymphocyte subsets, insulin secretion function