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

doi:10.3877/cma.j.issn.2095-655X.2021.04.010

Abstract

Abstract:

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.

Key words: Diabetes mellitus, type 2, Vitamin D, Mononuclear phagocyte system, Type M1/M2 polarization

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]. Chinese Journal of Diagnostics(Electronic Edition), 2021, 09(04): 259-263.

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References 22

[1]	Kobyliak N, Falalyeyeva T, Mykhalchyshyn G，et al.Effect of alive probiotic on insulin resistance in type 2 diabetes patients：randomized clinical trial[J]．Diabetes Metab Syndr, 2018，12(5)：617-624.
[2]	Myette-Côté É, Durrer C, Neudorf H，et al.The effect of a short-term low-carbohydrate，high-fat diet with or without postmeal walks on glycemic control and inflammation in type 2 diabetes: a randomized trial[J]．Am J Physiol Regul Integr Comp Physiol，2018，315(6)：1210-1219.
[3]	Ghadimi M, Foroughi F, Hashemipour S，et al.Randomized double-blind clinical trial examining the Ellagic acid effects on glycemic status，insulin resistance，antioxidant，and inflammatory factors in patients with type 2 diabetes[J]．Phytother Res，2021，35(2)：1023-1032.
[4]	Orliaguet L, Dalmas E, Drareni K，et al.Mechanisms of macrophage polarization in insulin signaling and sensitivity[J]．Front Endocrinol (Lausanne)，2020(11)：62.
[5]	Tardito S, Martinelli G, Soldano S, et al. Macrophage M1/M2 polarization and rheumatoid arthritis: a systematic review[J]．Autoimmun Rev，2019，18(11)：102397.
[6]	Wakade C, Giri B, Malik A，et al.Niacin modulates macrophage polarization in Parkinson's disease[J]．J Neuroimmunol，2018(320)：76-79.
[7]	Issa CM.Vitamin D and type 2 diabetes mellitus[J]．Adv Exp Med Biol，2017(996)：193-205.
[8]	Colotta F, Jansson B, Bonelli F．Modulation of inflammatory and immune responses by vitamin D[J]．J Autoimmun，2017( 85)：78-97.
[9]	张雪，孟强，孙琳．动脉钙化发生机制的研究进展[J/CD]．中华诊断学电子杂志，2017，5(4)：235-239.
[10]	中华医学会糖尿病学分会．中国2型糖尿病防治指南(2017年版)[J]．中国实用内科杂志，2018，38(4)：292-344.
[11]	Huang T, Afzal S, Yu C，et al.Vitamin D and cause-specific vascular disease and mortality: a Mendelian randomisation study involving 99，012 Chinese and 106，911 European adults[J]．BMC Med，2019，17(1)：160.
[12]	Angellotti E, D′Alessio D, Dawson-Hughes B，et al.Effect of vitamin D supplementation on cardiovascular risk in type 2 diabetes[J]．Clin Nutr，2019，38(5)：2449-2453.
[13]	Riek AE, Oh J, Darwech I, et al. Vitamin D₃ supplementation decreases a unique circulating monocyte cholesterol pool in patients with type 2 diabetes[J]．J Steroid Biochem Mol Biol，2018(177)：187-192.
[14]	Sassi F, Tamone C, D′Amelio P．Vitamin D：nutrient，hormone，and immunomodulator[J]．Nutrients，2018，10(11)：1656.
[15]	Surdu AM, Pînzariu O, Ciobanu DM，et al.Vitamin D and its role in the lipid metabolism and the development of atherosclerosis[J]．Biomedicines，2021，9(2)：172.
[16]	Charoenngam N, Holick MF.Immunologic effects of vitamin D on human health and disease[J]．Nutrients，2020，12(7)：2097.
[17]	Chen Y, Liu W, Sun T, et al.1，25-Dihydroxyvitamin D promotes negative feedback regulation of TLR signaling via targeting microRNA-155-SOCS1 in macrophages[J]．J Immunol，2013，190(7)：3687-3695.
[18]	Fadini GP, de Kreutzenberg SV, Boscaro E，et al.An unbalanced monocyte polarisation in peripheral blood and bone marrow of patients with type 2 diabetes has an impact on microangiopathy[J]．Diabetologia，2013，56(8)：1856-1866.
[19]	Yunna C, Mengru H, Lei W，et al.Macrophage M1/M2 polarization[J]．Eur J Pharmacol，2020(877)：173090.
[20]	Shapouri-Moghaddam A, Mohammadian S, Vazini H，et al.Macrophage plasticity，polarization，and function in health and disease[J]．J Cell Physiol，2018，233(9)：6425-6440.
[21]	Zhang X, Song Z, Guo Y，et al.The novel role of TRPC6 in vitamin D ameliorating podocyte injury in STZ-induced diabetic rats[J]．Mol Cell Biochem，2015，399(1/2)：155-165.
[22]	Zhang XL, Guo YF, Song ZX，et al.Vitamin D prevents podocyte injury via regulation of macrophage M1/M2 phenotype in diabetic nephropathy rats[J]．Endocrinology，2014，155(12)：4939-4950.

项目	25(OH)D缺乏组(n＝111)	25(OH)D非缺乏组(n＝39)	统计量	P值
年龄(岁，±s)	59.73±12.87	58.72±12.11	t＝0.43	0.669
性别(男/女，例)	70/41	26/13	χ²＝0.16	0.130
病程[年，M(P₂₅，P₇₅)]	10(3，15)	10(2，13)	Z＝-0.63	0.528
身高(m，±s)	1.66±0.08	1.65±0.08	t＝0.56	0.578
体重(kg，±s)	71.20±12.49	69.22±10.30	t＝0.89	0.375
体重指数(kg/m²，±s)	25.66±3.56	25.25±3.07	t＝0.64	0.521
腰围(cm，±s)	91.08±9.74	89.21±8.63	t＝1.07	0.289
臀围(cm，±s)	96.27±6.92	95.28±6.71	t＝0.78	0.440
腰臀比(±s)	0.95±0.07	0.94±0.06	t＝0.81	0.419
心率(次/min，±s)	79.86±11.32	79.18±10.02	t＝0.33	0.742
空腹血糖(mmol/L，±s)	7.95±2.90	8.12±2.90	t＝-0.32	0.747
餐后2 h血糖(mmol/L，±s)	12.70±3.80	13.41±4.56	t＝-0.96	0.336
糖化血红蛋白(%，±s)	9.02±2.10	9.13±2.56	t＝-0.27	0.284
肌酐(μmoI/L，±s)	67.52±2.35	70.15±3.50	t＝-0.59	0.383
低密度脂蛋白胆固醇(mmol/L，±s)	3.08±0.81	3.04±0.92	t＝0.29	0.770
25(OH)D(μg/L，±s)	13.97±3.63	24.63±3.71	t＝-15.67	0.001

项目	25(OH)D缺乏组(n＝111)	25(OH)D非缺乏组(n＝39)	统计量	P值
年龄(岁，±s)	59.73±12.87	58.72±12.11	t＝0.43	0.669
性别(男/女，例)	70/41	26/13	χ²＝0.16	0.130
病程[年，M(P₂₅，P₇₅)]	10(3，15)	10(2，13)	Z＝-0.63	0.528
身高(m，±s)	1.66±0.08	1.65±0.08	t＝0.56	0.578
体重(kg，±s)	71.20±12.49	69.22±10.30	t＝0.89	0.375
体重指数(kg/m²，±s)	25.66±3.56	25.25±3.07	t＝0.64	0.521
腰围(cm，±s)	91.08±9.74	89.21±8.63	t＝1.07	0.289
臀围(cm，±s)	96.27±6.92	95.28±6.71	t＝0.78	0.440
腰臀比(±s)	0.95±0.07	0.94±0.06	t＝0.81	0.419
心率(次/min，±s)	79.86±11.32	79.18±10.02	t＝0.33	0.742
空腹血糖(mmol/L，±s)	7.95±2.90	8.12±2.90	t＝-0.32	0.747
餐后2 h血糖(mmol/L，±s)	12.70±3.80	13.41±4.56	t＝-0.96	0.336
糖化血红蛋白(%，±s)	9.02±2.10	9.13±2.56	t＝-0.27	0.284
肌酐(μmoI/L，±s)	67.52±2.35	70.15±3.50	t＝-0.59	0.383
低密度脂蛋白胆固醇(mmol/L，±s)	3.08±0.81	3.04±0.92	t＝0.29	0.770
25(OH)D(μg/L，±s)	13.97±3.63	24.63±3.71	t＝-15.67	0.001

组别	例数	M1(%)	M2(%)	M1/M2
25(OH)D缺乏组	111	4.56±2.48	10.34±4.17	0.56±0.41
25(OH)D非缺乏组	39	3.27±1.97	10.76±5.92	0.42±0.27
t值		2.94	-0.30	2.01
P值		0.004	0.769	0.046

组别	例数	M1(%)	M2(%)	M1/M2
25(OH)D缺乏组	111	4.56±2.48	10.34±4.17	0.56±0.41
25(OH)D非缺乏组	39	3.27±1.97	10.76±5.92	0.42±0.27
t值		2.94	-0.30	2.01
P值		0.004	0.769	0.046

变量	B	SE	t值	P值	容忍度	方差膨胀因子
常量	1.53	3.07	0.50	0.619
年龄	0.04	0.02	2.26	0.025	0.68	1.46
血清25(OH)D水平	-0.12	0.03	-3.87	0.000	0.98	1.03

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