Increased glycemic variability results in abnormal differentiation of T cell subpopulation in type 2 diabetes patients

Qi Sun; Ping Yang; Qing-Wei Gu; Wen-Sa Gu; Wei Wang; Jie Wang; Xiao-Ming Mao

doi:10.1016/j.jdiacomp.2024.108738

Increased glycemic variability results in abnormal differentiation of T cell subpopulation in type 2 diabetes patients

J Diabetes Complications. 2024 Mar 27;38(6):108738. doi: 10.1016/j.jdiacomp.2024.108738. Online ahead of print.

Authors

Qi Sun¹, Ping Yang¹, Qing-Wei Gu¹, Wen-Sa Gu¹, Wei Wang¹, Jie Wang¹, Xiao-Ming Mao²

Affiliations

¹ Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China.
² Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China. Electronic address: maoxming@njmu.edu.cn.

PMID: 38643556
DOI: 10.1016/j.jdiacomp.2024.108738

Abstract

Aims: We aimed to investigate the association between glycemic variability (GV) and the abnormal differentiation of T-cell subpopulations in patients with type 2 diabetes mellitus (T2DM).

Methods: In total, 108 hospitalized patients with T2DM were enrolled and divided into two subgroups (normal glycemic excursion (NGE) and high glycemic excursion (HGE)) according to their mean amplitude of glycemic excursion (MAGE) level. The MAGE was evaluated via continuous glucose monitoring for 72 h consecutively. Flow cytometry was used to determine the proportions of T cell subpopulations.

Results: The T helper (Th) 1 cell/Th2 cell ratio was significantly higher, and the proportion of regulatory T cells (Tregs) was significantly lower in the NGE group than in the HGE group (all P < 0.05). After fully adjusting for confounders, the MAGE was positively associated with the Th1 cell/Th2 cell ratio (β = 0.370; P = 0.009) and negatively associated with the proportion of Tregs (β = -0.554; P = 0.001).

Conclusion: The MAGE was an independent risk factor for abnormally high Th1 cell/Th2 cell ratio and proportion of Tregs. Abnormal differentiation of T cell subpopulations induced by GV may impair β-cell function, aggravate insulin resistance, and contribute to the development of diabetic complications.

Keywords: Continuous glucose monitoring; Mean amplitude of glycemic excursion; T lymphocyte; Type 2 diabetes mellitus.