Correlation between glycemic control and T cell memory subsets in type 2 diabetes mellitus patients

doi:10.3969/j.issn.1673-8640.2025.01.011

Abstract

Abstract:

Objective To investigate the influence of poor glycemic control in type 2 diabetes mellitus （T2DM） patients on T cell memory subsets and immune marker expression. Methods Peripheral blood samples were collected from 170 T2DM patients（T2DM group）and 85 healthy subjects （healthy control group） in Tongren Hospital of Shanghai Jiao Tong University from January 2022 to January 2024. According to glycated hemoglobin A1c （HbA_1c）levels，T2DM patients were classified into 2 groups，patients with good glycemic control（HbA_1c<7%） and patients with poor glycemic control（HbA_1c≥7%）. Flow cytometry was used to assess the proportion of T cell memory subsets，distinguishing between naive T cell（T_Nai），central memory T cell（T_CM），effector memory T cell（T_EM） and terminally differentiated effector memory T cell（T_EMRA） subgroups. The expressions of T_CM and T_EM membrane molecules （CD38，CD25 and HLA-DR ）were determined. Biochemical indicator determination results were collected，including fasting plasma glucose，HbA_1c，total cholesterol （TC），triglyceride （TG），low-density lipoprotein cholesterol （LDL-C） and high-density lipoprotein cholesterol （HDL-C）. Linear regression was used to assess the correlation between T cell memory subsets and membrane molecules and patients' age and HbA_1c level. Results Compared with healthy control group，T2DM group showed increased levels of fasting plasma glucose，HbA_1c and TG （P<0.05） and a decreased level of HDL-C（P<0.000 1）. There was no statistical significance in TC and LDL-C between the 2 groups （P>0.05）. T2DM patients showed an increased percentage of CD8⁺T_CM cells （P=0.006 7）. There was no statistical significance in the other T cell memory subsets between the 2 groups （P>0.05）. Compared with healthy control group，in T2DM group CD4⁺CD38⁺T_CM%，CD4⁺CD25⁺T_CM%，CD4⁺HLA-DR⁺T_CM%，CD4⁺CD38⁺T_EM%，CD4⁺HLA-DR⁺T_EM%，CD8⁺CD38⁺T_CM%，CD8⁺HLA-DR⁺T_CM% and CD8⁺HLA-DR⁺T_EM% were decreased（P<0.05）. Compared with T2DM patients with good glycemic control，T2DM patients with poor glycemic control showed an increased CD8⁺T_CM%（P<0.05），a decreased CD4⁺CD38⁺T_CM%（P<0.000 1），and a decreased CD4⁺CD38⁺T_EM%（P<0.05）. The CD4⁺CD38⁺T_CM% was negatively related to HbA_1c level and age in T2DM patients（r values were -0.512 6 and -0.234 2，P<0.000 1，P=0.002 1，respectively）. Conclusions Poor glycemic control effects T cell immune function. The CD4⁺CD38⁺T_CM% reduces along with the increase of HbA_1c in T2DM patients.

Key words: T cell, CD38, Type 2 diabetes mellitus, Glycemic control

CLC Number:

R446.1

GAN Chenxin, CHEN Minghui, WANG Yajie, WU Jiaoxiang, FANG Fengqin, LIN Jinpiao, SHENG Huiming. Correlation between glycemic control and T cell memory subsets in type 2 diabetes mellitus patients[J]. Laboratory Medicine, 2025, 40(1): 59-65.

Figures/Tables 8

References 29

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抗体	荧光素	克隆号	品牌	货号
抗CD3抗体	PERCP	OKT3	美国Biolegend公司	Cat# 317338
抗CD4抗体	Alexa Fluor 700	OKT4	美国Biolegend公司	Cat# 317426
抗CD8抗体	APC-Cy7	SK1	美国BD公司	Cat# 557834
抗CD45RA抗体	BV510	HI100	美国Biolegend公司	Cat# 304142
抗CD62L抗体	BV605	DREG-56	美国Biolegend公司	Cat# 304834
抗CD38抗体	APC	S17015F	美国Biolegend公司	Cat# 397212
抗CD25抗体	FITC	M-A251	美国Biolegend公司	Cat# 356106
抗HLA-DR抗体	BV711	L243	美国Biolegend公司	Cat# 307644

抗体	荧光素	克隆号	品牌	货号
抗CD3抗体	PERCP	OKT3	美国Biolegend公司	Cat# 317338
抗CD4抗体	Alexa Fluor 700	OKT4	美国Biolegend公司	Cat# 317426
抗CD8抗体	APC-Cy7	SK1	美国BD公司	Cat# 557834
抗CD45RA抗体	BV510	HI100	美国Biolegend公司	Cat# 304142
抗CD62L抗体	BV605	DREG-56	美国Biolegend公司	Cat# 304834
抗CD38抗体	APC	S17015F	美国Biolegend公司	Cat# 397212
抗CD25抗体	FITC	M-A251	美国Biolegend公司	Cat# 356106
抗HLA-DR抗体	BV711	L243	美国Biolegend公司	Cat# 307644

组别	例数	年龄/岁		性别		体重指数/（kg·m^-2）	空腹血糖/（mmol·L^-1）
组别	例数	年龄/岁		男/例	女/例	体重指数/（kg·m^-2）	空腹血糖/（mmol·L^-1）
T2DM组	170	63（55~70）		100	70	24.84（22.49~27.39）	6.50（5.50~7.70）
正常对照组	85	64（52~70）		50	35	24.58（22.88~25.91）	5.10（4.90~5.40）
统计值		7 008		0		6 587	2 844
P值		0.695 1		1.000 0		0.250 1	<0.000 1
组别	HbA_1c/%		TC/（mmol·L^-1）		TG/（mmol·L^-1）	LDL-C/（mmol·L^-1）	HDL-C/（mmol·L^-1）
T2DM组	6.95（6.50~8.10）		4.68（3.88~5.54）		1.35（0.96~1.96）	2.91（2.14~3.70）	1.13（0.94~1.41）
正常对照组	5.60（5.50~5.70）		4.59（3.94~5.33）		1.05（0.80~1.66）	2.87（2.48~3.43）	1.41（1.21~1.71）
统计值	429		6 995		5 729	7 148	3 996
P值	<0.000 1		0.678 0		0.007 0	0.889 0	<0.000 1

组别	例数	年龄/岁		性别		体重指数/（kg·m^-2）	空腹血糖/（mmol·L^-1）
组别	例数	年龄/岁		男/例	女/例	体重指数/（kg·m^-2）	空腹血糖/（mmol·L^-1）
T2DM组	170	63（55~70）		100	70	24.84（22.49~27.39）	6.50（5.50~7.70）
正常对照组	85	64（52~70）		50	35	24.58（22.88~25.91）	5.10（4.90~5.40）
统计值		7 008		0		6 587	2 844
P值		0.695 1		1.000 0		0.250 1	<0.000 1
组别	HbA_1c/%		TC/（mmol·L^-1）		TG/（mmol·L^-1）	LDL-C/（mmol·L^-1）	HDL-C/（mmol·L^-1）
T2DM组	6.95（6.50~8.10）		4.68（3.88~5.54）		1.35（0.96~1.96）	2.91（2.14~3.70）	1.13（0.94~1.41）
正常对照组	5.60（5.50~5.70）		4.59（3.94~5.33）		1.05（0.80~1.66）	2.87（2.48~3.43）	1.41（1.21~1.71）
统计值	429		6 995		5 729	7 148	3 996
P值	<0.000 1		0.678 0		0.007 0	0.889 0	<0.000 1

组别	例数		CD8⁺T_Nai%/%	CD8⁺T_CM%/%	CD8⁺T_EM%/%	CD8⁺T_EMRA%/%
T2DM组	170		15.45（9.79~22.30）	14.15（10.30~20.60）	41.35（34.20~49.20）	22.25（14.40~35.40）
正常对照组	85		14.90（7.84~23.60）	11.90（8.58~15.50）	40.40（31.40~51.30）	25.60（16.20~35.80）
U值			7 012	5 720	7 082	6 539
P值			0.700 6	0.006 7	0.796 1	0.216 3
组别		CD4⁺T_Nai%/%		CD4⁺T_CM%/%	CD4⁺T_EM%/%	CD4⁺T_EMRA%/%
T2DM组		26.60（19.10~36.50）		39.00（33.60~43.50）	29.85（23.80~36.50）	1.20（0.64~2.73）
正常对照组		29.10（18.80~37.20）		38.60（29.30~43.30）	28.50（22.30~37.90）	1.28（0.57~2.76）
U值		6 736		6 595	6 882	7 169
P值		0.378 5		0.256 1	0.536 1	0.918 9