非酒精性脂肪性肝病患者外周血CD4~+CD25~+Foxp3~+调节性T细胞的变化及意义

目的观察非酒精性脂肪性肝病患者外周血单个核细胞(PBMC)CD4+CD25+Foxp3+调节性T细胞的变化及与胰岛素抵抗的关系,初步探讨其意义。方法 46例非酒精性脂肪性肝病患者根据体质指数分为肥胖组(21例)及非肥胖组(25例),42名健康医务工作者作为健康对照。检测空腹胰岛素及空腹血糖水平,计算胰岛素抵抗指数;采用流式细胞术检测患者外周血PBMC CD4+CD25+Foxp3+调节性T细胞数目,并计算CD4+CD25+Foxp3+调节性T细胞占CD4+T淋巴细胞的百分比;分析CD4+CD25+Foxp3+调节性T细胞与胰岛素抵抗间的关系。结果与健康对照组相比,非酒精性脂肪性肝病患者外周血PBMC CD4+CD25+Foxp3+调节性T细胞数及其占CD4+T淋巴细胞的百分比均显著下降(P<0.01,P<0.05),但在肥胖组与非肥胖组间差异均无统计学意义(P>0.05);肥胖者胰岛素抵抗指数较非肥胖者显著升高(P<0.01);肥胖组内PBMC CD4+CD25+Foxp3+调节性T细胞数值及其占CD4+T淋巴细胞的百分比均与胰岛素抵抗指数呈明显负相关(r=-0.989,P<0.01)。结论非酒精性脂肪性肝病患者PBMC CD4+CD25+Foxp3+调节性T细胞数目和比例减少,可能存在自身免疫调节功能的紊乱;PBMC CD4+CD25+Foxp3+调节性T细胞可能通过调节胰岛素抵抗参与非酒精性脂肪性肝病的形成和发展。

Clinical significance of peripheral CD4~+CD25~+Foxp3~+ regulatory T cells in nonalcoholic fatty liver disease patients

Objective To investigate the clinical significance of peripheral CD4+CD25+Foxp3+ regulatory T cells in nonalcoholic fatty liver disease(NAFLD) patients.MethodsA total of 46 NAFLD patients were divided into obesity group(n=21)and non-obesity group(n=25)by body mass Index(BMI).Fast blood glucose(FBG) and fast insulin(FINS) were measured for calculating the insulin resistance index.The CD4+CD25+Foxp3+ regulatory T cells were detected by flow cytometry.The relationship between CD4+CD25+Foxp3+ regulatory T cells and insulin resistance was also statistically analyzed.ResultsThe proportion and number of peripheral CD4+CD25+Foxp3+ regulatory T cells were significantly lower in nonalcoholic fatty liver disease patients(P<0.01,P<0.05)than in controls.There was no statistical difference in peripheral CD4+CD25+Foxp3+ regulatory T cells between the obesity and non-obesity groups.Insulin resistance index was significantly higher in obesity group than in non-obesity group(P<0.01).The proportion and number of CD4+CD25+Foxp3+ regulatory T cells were negatively correlated with the insulin resistance(r=-0.989,P<0.01).ConclusionLow proportion and number of peripheral CD4+CD25+Foxp3+ regulatory T cells were associated with NAFLD.