Th17/Treg与2型糖尿病患者胰岛素抵抗及胰岛β细胞功能的关系

doi:10.20223/j.cnki.1000-8535.2025.10.007

广州医药 ›› 2025, Vol. 56 ›› Issue (10): 1372-1377.DOI: 10.20223/j.cnki.1000-8535.2025.10.007

Th17/Treg与2型糖尿病患者胰岛素抵抗及胰岛β细胞功能的关系

赖向恒¹, 侯泽鑫², 廖尚华³

1 贵州医科大学第二附属医院内分泌代谢科（贵州凯里 556000）
2 贵州医科大学第二附属医院肿瘤科（贵州凯里 556000）
3 新州镇中心卫生院内科（贵州黄平 563406）

收稿日期:2024-08-06 出版日期:2025-10-20 发布日期:2025-11-28
通讯作者: 侯泽鑫,E-mail：zexinhou@163.com
基金资助:
贵州省卫健委课题（gzwkj2024-314）; 黔东南州科学技术局课题（黔东南科合J字【2023】94号）

Relationship among Th17/Treg,insulin resistance and islet β cell function in type 2 diabetic patients

LAI Xiangheng¹, HOU Zexin², LIAO Shanghua³

1 Department of Endocrinology and Metabolism,the Second Affiliated Hospital of Guizhou Medical University,Kaili 556000,China
2 Department of Oncology,the Second Affiliated Hospital of Guizhou Medical University,Kaili 556000,China
3 Internal Medicine,Xinzhou town center health center,Huangping 563406,China

Received:2024-08-06 Online:2025-10-20 Published:2025-11-28

摘要/Abstract

摘要： 目的观察辅助性T17细胞（Th17）与调节性T细胞（Treg）比值与2型糖尿病（T2DM）患者胰岛素抵抗及胰岛β细胞功能的关系。方法纳入2022年4月—2023年4月在贵州医科大学第二附属医院内分泌科住院及健康体检人群各100例,分为糖耐量正常组（NGT组,n=100）和T2DM组（n=100）,分别测定糖化血红蛋白（HbA1c）、空腹血糖（FPG）、甘油三酯（TG）等生化指标,电化学发光法测定空腹胰岛素（FINS）,稳态模型计算胰岛β细胞功能指数（HOMA-β）、胰岛素抵抗指数（HOMA-IR）及胰岛素敏感指数（HOMA-ISI）。流式细胞术检测Th17、Treg水平。HOMA-IR、HOMA-β和HOMA-ISI的影响因素采用多元线性回归分析。结果与NGT组相比,T2DM组BMI、FPG、HbA1c、LDL-C 、TG、TC、FINS、HOMA-IR、Th17及Th17/Treg水平均升高（P<0.01）,HDL-C、HOMA-β、HOMA-ISI、Treg水平均降低,且差异有统计学意义（P<0.01）。Th17与BMI（r=0.251,P<0.001）及HOMA-IR（r=0.305,P<0.001）呈正相关;与HOMA-β（r=-0.204,P<0.001）及HOMA-ISI（r=-0.359,P<0.001）呈负相关。Treg与HOMA-ISI之间呈正相关（r=0.170,P=0.008）,而与HOMA-IR呈负相关（r=-0.153,P=0.017）;Th17/Treg与BMI（r=0.332,P<0.001）及HOMA-IR（r=0.374,P<0.001）;与HOMA-β（r=-0.249,P<0.001）及HOMA-ISI（r=-0.427,P<0.001）呈负相关。多元线性回归分析显示,Th17/Treg是HOMA-IR（β=5.915）升高及HOMA-ISI（β=-2.557）下降的影响因素（P<0.01）。结论 Th17/Treg可能通过影响胰岛素抵抗、降低胰岛素敏感性参与T2DM的发生。

关键词: 2型糖尿病, 辅助性T17细胞, 调节性T细胞, 胰岛素抵抗

Abstract: Objective To explore the relationship among the proportion of helper T17 cells（Th17）to regulatory T cells（Treg）,insulin resistance,and the function of islet beta cells．Methods One hundred cases of hospitalized patients and 100 cases of health check-ups people in the Department of Endocrinology of the Second Affiliated Hospital of Guizhou Medical University from April 2022 to April 2023 were included．Patients were divided into normal glucose tolerance group（NGT group,n=100）and type 2 diabetes mellitus group（T2DM group,n=100）．The biochemical indexes of HbA1c,fasting blood glucose（FPG）,triglyceride（TG）and fasting insulin（FINS）were determined by electrochemiluminescence．Islet beta cell function index（HOMA-β）,insulin resistance index（HOMA-IR）and insulin sensitivity index（HOMA-ISI）were calculated in homeostasis model．The levels of Th17 and Treg were detected by flow cytometry．Spearman was used to analyze the correlation between indicators,and multiple linear regression analysis was used to analyze the influencing factors of HOMA-IR,HOMA-β and HOMA-ISI．Results In contrast to the NGT group,the T2DM group exhibited elevated levels of BMI,FPG,HbA1c,LDL-C,TG,TC,FINS,HOMA-IR,Th17 and Th17/Treg,with these variances being signifincantly different（P<0.01）．There was a notable reduction in the levels of HDL-C,HOMA-β,HOMA-ISI,Treg,with those changes being significantly different（P<0.01）．Th17 was positively correlated with BMI（r=0.251,P<0.001）and HOMA-IR（r=0.305,P<0.001）,it was negatively correlated with HOMA-β（r=-0.204,P<0.001）and HOMA-ISI（r=-0.359,P<0.001）．Treg was positively correlated with HOMA-ISI（r=0.170,P=0.008）,while it was negatively correlated with HOMA-IR（r=-0.153,P=0.017）．The ratio of Th17/Treg was positively correlated with BMI（r=0.332,P<0.001）and HOMA-IR（r=0.374,P<0.001）,it was negatively correlated with HOMA-β（r=-0.249,P<0.001）and HOMA-ISI（r=-0.427,P<0.001）．Multiple linear regression analysis showed that Th17/Treg was an influential factor in the increase of HOMA-IR（β=5.915）and the decrease of HOMA-ISI（β=-2.557）（P<0.01）．Conclusions Th17/Treg may be involved in the development of T2DM by affecting insulin resistance and reducing insulin sensitivity．

Key words: type 2 diabetes mellitus, Th17, Treg, insulin resistance

赖向恒, 侯泽鑫, 廖尚华. Th17/Treg与2型糖尿病患者胰岛素抵抗及胰岛β细胞功能的关系[J]. 广州医药, 2025, 56(10): 1372-1377.

LAI Xiangheng, HOU Zexin, LIAO Shanghua. Relationship among Th17/Treg,insulin resistance and islet β cell function in type 2 diabetic patients[J]. Guangzhou Medical Journal, 2025, 56(10): 1372-1377.

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Th17/Treg与2型糖尿病患者胰岛素抵抗及胰岛β细胞功能的关系

Relationship among Th17/Treg,insulin resistance and islet β cell function in type 2 diabetic patients

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