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老年2型糖尿病患者人巨细胞病毒感染与脂糖代谢、胰岛素抵抗及免疫失衡的关系研究
引用本文:李 纯,熊 静,廖 娟,戴湘怡,王俊懿. 老年2型糖尿病患者人巨细胞病毒感染与脂糖代谢、胰岛素抵抗及免疫失衡的关系研究[J]. 现代生物医学进展, 2023, 0(4): 782-786
作者姓名:李 纯  熊 静  廖 娟  戴湘怡  王俊懿
作者单位:长沙市第三医院老年病科 湖南 长沙 410000
基金项目:湖南省卫生计生委科研计划项目(B20160426)
摘    要:摘要 目的:探讨老年2型糖尿病(T2DM)患者人巨细胞病毒(HCMV)感染与脂糖代谢、胰岛素抵抗及免疫失衡的关系。方法:选取2021年2月~2022年3月长沙市第三医院收治的老年T2DM患者100例为研究组,选取同期来体检健康的志愿者60例作为对照组。根据HCMV-脱氧核糖核酸(DNA)检测结果将研究组分为阳性组41例和阴性组59例。检测并比较对照组、研究组HCMV-DNA载量、T淋巴细胞亚群(CD4+、CD8+、CD4+/CD8+)、脂糖代谢[高密度脂蛋白胆固醇(HDL-C)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、空腹血糖(FBG)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)]、胰岛素抵抗[空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)]。采用Pearson相关性分析老年T2DM患者HCMV感染与脂糖代谢、胰岛素抵抗及免疫失衡的关系。结果:研究组的HCMV-DNA阳性率、HCMV-DNA载量高于对照组,阴性率低于对照组(P<0.05)。阳性组、阴性组的CD4+、CD4+/CD8+低于对照组,且阳性组低于阴性组(P<0.05)。阳性组、阴性组的CD8+高于对照组,且阳性组高于阴性组(P<0.05)。阳性组、阴性组的HbA1c、FBG、TC、TG、LDL-C高于对照组,且阳性组高于阴性组(P<0.05)。阳性组、阴性组的HDL-C低于对照组,且阳性组低于阴性组(P<0.05)。阳性组、阴性组的HOMA-IR、FINS高于对照组,且阳性组高于阴性组(P<0.05)。Pearson相关性分析结果显示,HCMV-DNA载量与CD4+、CD4+/CD8+、HDL-C呈负相关(P<0.05),而与CD8+、HbA1c、FBG、TC、TG、LDL-C、FINS、HOMA-IR呈正相关(P<0.05)。结论:HCMV病毒感染可导致老年T2DM患者脂糖代谢紊乱,促进胰岛素抵抗,加重免疫失衡,加速疾病进展。

关 键 词:老年;2型糖尿病;人巨细胞病毒;脂糖代谢;胰岛素抵抗;免疫失衡
收稿时间:2022-06-28
修稿时间:2022-07-23

Study on the Relationship between Human Cytomegalovirus Infection and Lipid and Glucose Metabolism, Insulin Resistance and Immune Imbalance in Elderly Patients with Type 2 Diabetes
Abstract:ABSTRACT Objective: To explore the relationship between human cytomegalovirus (HCMV) infection and lipid and glucose metabolism, insulin resistance and immune imbalance in elderly patients with type 2 diabetes(T2DM). Methods: 100 elderly patients with T2DM who were admitted to Changsha Third Hospital from February 2021 to March 2022 were selected as the study group, and 60 healthy volunteers who came to for physical examination in the same period were selected as the control group. The study group was divided into 41 cases in the positive group and 59 cases in the negative group according to the HCMV- deoxyribonucleic acid (DNA) test results. HCMV-DNA load, T lymphocyte subsets (CD4+, CD8+, CD4+/CD8+), lipid and glucose metabolism [high density lipoprotein-cholesterol (HDL-C), glycosylated hemoglobin (HbA1c), total cholesterol (TC), fasting blood glucose (FBG), triacylglycerol (TG), low density lipoprotein- cholesterol (LDL-C)], and insulin resistance [fasting insulin (FINS), insulin resistance index (HOMA-IR)] were detected and compared between the control group and the study group. Pearson correlation was used to analyze the relationship between HCMV infection and lipid and glucose metabolism, insulin resistance and immune imbalance in elderly patients with T2DM. Results: The HCMV-DNA positive rate and HCMV-DNA load in the study group were higher than those in the control group, and the negative rate was lower than that in the control group (P<0.05). CD4+ and CD4+/CD8+ in the positive group and the negative group were lower than those in the control group, and those in the positive group were lower than those in the negative group (P<0.05). CD8+ in the positive group and the negative group was higher than that in the control group, and that in the positive group was higher than that in the negative group (P<0.05). HbA1c, FBG, TC, TG, LDL-C in the positive group and the negative group were higher than those in the control group, and those in the positive group were higher than those in the negative group (P<0.05). HDL-C in the positive group and the negative group was lower than that in the control group, and that in the positive group was lower than that in the negative group (P<0.05). HOMA-IR and FINS in the positive group and the negative group were higher than those in the control group, and those in the positive group were higher than those in the negative group (P<0.05). Pearson correlation analysis showed that HCMV-DNA load was negatively correlated with CD4+, CD4+/CD8+, HDL-C (P<0.05), but positively correlated with CD8+, HbA1c, FBG, TC, TG, LDL-C, FINS, HOMA-IR (P<0.05). Conclusion: HCMV virus infection can lead to the disorder of lipid and glucose metabolism in elderly patients with T2DM, promote insulin resistance, aggravate immune imbalance, and accelerate the progress of the disease.
Keywords:Elderly   Type 2 diabetes   Human cytomegalovirus   Lipid and glucose metabolism   Insulin resistance   Immune imbalance
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