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中华诊断学电子杂志 ›› 2021, Vol. 09 ›› Issue (04) : 259 -263. doi: 10.3877/cma.j.issn.2095-655X.2021.04.010

临床研究

2型糖尿病患者血清维生素D水平与单核巨噬细胞系统极化的相关性研究
洪秀韬1, 陈凤玲1, 刘卉芳1, 杨燕1, 姚艺璇1, 徐恒仕2,()   
  1. 1. 200011 上海交通大学医学院附属第九人民医院内分泌科
    2. 200011 上海交通大学医学院附属第九人民医院输血科
  • 收稿日期:2021-03-28 出版日期:2021-11-26
  • 通信作者: 徐恒仕

The correlation between serum vitamin D level and polarization of monocytes/macrophages system in patients with type 2 diabetes

Xiutao Hong1, Fengling Chen1, Huifang Liu1, Yan Yang1, Yixuan Yao1, Hengshi Xu2,()   

  1. 1. Department of Endocrinology, The Ninth People′s Hospital Affiliated to School of Medicine, Shanghai Jiaotong University, Shanghai 200011, China
    2. Department of Blood Transfusion, The Ninth People′s Hospital Affiliated to School of Medicine, Shanghai Jiaotong University, Shanghai 200011, China
  • Received:2021-03-28 Published:2021-11-26
  • Corresponding author: Hengshi Xu
引用本文:

洪秀韬, 陈凤玲, 刘卉芳, 杨燕, 姚艺璇, 徐恒仕. 2型糖尿病患者血清维生素D水平与单核巨噬细胞系统极化的相关性研究[J/OL]. 中华诊断学电子杂志, 2021, 09(04): 259-263.

Xiutao Hong, Fengling Chen, Huifang Liu, Yan Yang, Yixuan Yao, Hengshi Xu. The correlation between serum vitamin D level and polarization of monocytes/macrophages system in patients with type 2 diabetes[J/OL]. Chinese Journal of Diagnostics(Electronic Edition), 2021, 09(04): 259-263.

目的

探讨2型糖尿病患者血清25-羟维生素D[25(OH)D]水平及单核/巨噬细胞的极化状态,并分析其相关性。

方法

选择2019年5月至8月上海交通大学医学院附属第九人民医院内分泌科收治的2型糖尿病患者150例,检测患者血清25(OH)D水平,并将其分为缺乏组[25(OH)D<20 μg/L](n=111)和非缺乏组[25(OH)D≥20 μg/L](n=39),同时采用流式细胞术检测患者外周血中M1型单核细胞和M2型单核细胞的比例,并计算M1/M2的比值。采用两独立样本t检验比较两组外周血单核细胞M1、M2型的比例以及M1/M2的差异;通过Pearson相关性分析研究血清25(OH)D水平与外周血单核细胞M1、M2型比例的相关性,并采用多元线性回归分析外周血单核细胞M1/M2型极化的相关因素。

结果

缺乏组血清25(OH)D水平为(13.97±3.63)μg/L,非缺乏组为(24.63±3.71)μg/L,差异有统计学意义(t=-15.67,P<0.01)。缺乏组外周血M1型单核细胞比例[(4.56±2.48)%]高于非缺乏组[(3.27±1.97)%],差异具有统计学意义(t=2.94,P<0.01);缺乏组M1/M2比值(0.56±0.41)高于非缺乏组(0.42±0.27),差异具有统计学意义(t=2.01,P<0.05)。血清25(OH)D水平与外周血单核细胞M1型比例及M1/M2比值之间存在负相关性(r=-0.31,-0.18;均P<0.05)。在排除混杂因素后,血清25(OH)D是M1型单核细胞的线性负相关因素(B=-0.12,P<0.01)。

结论

缺乏维生素D的2型糖尿病患者存在促炎型M1型单核细胞增多和M1/M2比值的升高,维生素D缺乏可能与2型糖尿病患者单核/巨噬细胞极化失衡相关。

Objective

To explore the serum 25-hydroxyvitamin D [25(OH)D] level and the polarization state of monocytes/macrophages in peripheral blood of patients with type 2 diabetes, and their correlation.

Methods

A total of 150 patients with type 2 diabetes who were admitted to the Endocrinology Department of the Ninth People′s Hospital Affiliated to School of Medicine, Shanghai Jiaotong University from May to August 2019 were selected. The serum 25(OH)D levels of patients were detected, and the patients were divided into deficiency group [serum 25(OH)D<20 μg/L] (n=111) and non-deficiency group [serum 25(OH)D≥20 μg/L] (n=39). At the same time, flow cytometry was used to detect the ratio of M1-type monocytes and M2-type monocytes in the peripheral blood of patients, the ratio of M1/M2 was calculated. The proportion of M1 and M2 monocytes and the difference of M1/M2 in peripheral blood between the two groups were compared by t test of two independent samples. The correlation between serum 25(OH)D level and the ratio of M1 and M2 type of monocytes in peripheral blood was studied by Pearson correlation analysis, and the factors related to M1 and M2 type polarization of monocytes in peripheral blood were analyzed by multiple linear regression.

Results

The levels of serum 25(OH)D in the deficiency and non-deficiency groups were (13.97±3.63)μg/L and (24.63±3.71)μg/L, the difference was statistically significant (t=-15.67, P<0.01). The proportion of M1 in peripheral blood of the deficiency group(4.56±2.48)% was higher than that of the non-deficiency group (3.27±1.97)%, the difference was statistically significant (t=2.94, P<0.01). The M1/M2 in the deficiency group (0.56±0.41) was higher than that of the non-deficiency group (0.42±0.27), the difference was statistically significant (t=2.01, P<0.05). There were negative correlations between serum 25(OH)D level and M1 ratio and M1/M2 ratio in peripheral blood (r=-0.31, -0.18, all P<0.05). After excluding confounding factors, serum 25(OH)D level and M1 ratio had a linear negative correlation (B=-0.12, P<0.01).

Conclusion

Type 2 diabetes patients with vitamin D insufficiency showed an increase of pro-inflammatory type M1 cells and a higher ratio of M1/M2, and vitamin D deficiency may be related to the imbalance of monocytes/macrophages in patients with type 2 diabetes.

表1 两组T2DM患者临床特征比较
表2 两组T2DM患者外周血M1、M2型单核细胞极化情况比较(±s)
表3 T2DM患者外周血M1型单核细胞比例 相关因素的多元线性回归分析
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