Correlation of CD3+/CD4+, and serum CK-18 fragment levels with glucose and lipid metabolism in elderly type 2 diabetes patients with nonalcoholic fatty liver disease - PubMed (original) (raw)

. 2021 Apr 15;13(4):2546-2554.

eCollection 2021.

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Correlation of CD3+/CD4+, and serum CK-18 fragment levels with glucose and lipid metabolism in elderly type 2 diabetes patients with nonalcoholic fatty liver disease

Chunzhi Zhao et al. Am J Transl Res. 2021.

Abstract

Objective: To test the correlation of helper T lymphocytes (CD3+/CD4+), and cytokeratin 18 fragment (CK-18) with glucose and lipid metabolism in elderly patients with type 2 diabetes mellitus (T2DM) and nonalcoholic fatty liver disease (NAFLD).

Methods: A total of 108 patients with T2DM hospitalized in Geriatrics, Taizhou People's Hospital from August 2019 to December 2020 were obtained and grouped into' Non-NAFLD group (58 patients) and NAFLD group (50 patients) according to the patients' conditions. Another 50 healthy people were obtained as the control group (CG). The BMI was tested, and the elbow venous blood was collected. The indexes of blood glucose, liver and kidney function (ALT, AST, creatinine, urea nitrogen), blood lipid (triglyceride, total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol) and blood uric acid were detected. CD3+/CD4+ in elbow venous blood was tested using flow cytometry, and CK-18 was tested using ELISA. Pearson correlation coefficient was applied to test the correlation of CD3+/CD4+, CK-18 with glucose and lipid metabolism in NAFLD group.

Results: Compared with the CG, CK-18 in the other two groups were elevated, and CK-18 in the NAFLD group were elevated compared to the Non-NAFLD group. Compared with the CG, CD3+ and CD4+ in the other two groups were decreased, and CD3+ and CD4+ in the NAFLD group decreased compared to the Non-NAFLD group. Correlation analysis revealed that both CD3+ and CD4+ had a negative correlation with FPG, HbA1C, FINS, HOMA-IR, TG, TC, HDL and LDL, while CK-18 had a positive correlation with these indexes. ROC curve revealed that the AUC values of CK-18, CD3+ and CD4+ for NAFLD in elderly T2DM patients were 0.875, 0.867, and 0.871, respectively. Logistic regression analysis revealed that FINS, HOMA-IR, CK-18, CD3+ and CD4+ were all related factors leading to NAFLD in elderly T2DM patients.

Conclusion: CD3+/CD4+, and CK-18 were correlated with glucose and lipid metabolism in elderly T2DM patients with NAFLD. They may be related to the development of T2DM and NAFLD, and these indexes can be used as biological diagnostic indicators for elderly T2DM patients with NAFLD.

Keywords: CD3+/CD4+; Type 2 diabetes mellitus; cytokeratin 18 fragment; glucose and lipid metabolism; nonalcoholic fatty liver disease.

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Conflict of interest statement

None.

Figures

Figure 1

Figure 1

CK-18, CD3+, and CD4+ in the three groups. A: Compared with the control group (CG), CK-18 in the other two groups was elevated, and CK-18 in NAFLD group was elevated compared to the Non-NAFLD group. B, C: Compared with the CG, CD3+, and CD4+ in the other two groups were decreased, and CD3+ and CD4+ in NAFLD group were decreased compared to the Non-NAFLD group (P < 0.05). Note: * means compared with the CG, P < 0.05; # means compared with Non-NAFLD group, P < 0.05.

Figure 2

Figure 2

Comparison of CD3+, CD4+, and CK-18 before and after treatment. A: After treatment, CK-18 in both groups was elevated, and CK-18 in NAFLD group was higher than that of the Non-NAFLD group. B, C: After treatment, CD3+ and CD4+ in both groups decreased, and CD3+ and CD4+ in NAFLD group were decreased compared to the Non-NAFLD group. Note: a means a comparison before and after treatment, P < 0.05; b means compared to Non-NAFLD group, P < 0.05.

Figure 3

Figure 3

Correlation of CK-18 with glucose and lipid metabolism. A: CK-18 was positively correlated with FPG. B: CK-18 was positively correlated with HbA1C. C: CK-18 was positively correlated with FINS. D: CK-18 was positively correlated with HOMA-IR. E: CK-18 was positively correlated with TG. F: CK-18 was positively correlated with TC. G: CK-18 was positively correlated with HDL. H: CK-18 was positively correlated with LDL.

Figure 4

Figure 4

Correlation of CD3+ with glucose and lipid metabolism. A: CD3+ was negatively correlated with FPG. B: CD3+ was negatively correlated with HbA1C. C: CD3+ was negatively correlated with FINS. D: CD3+ was negatively correlated with HOMA-IR. E: CD3+ was negatively correlated with TG. F: CD3+ was negatively correlated with TC. G: CD3+ was negatively correlated with HDL. H: CD3+ was negatively correlated with LDL.

Figure 5

Figure 5

Correlation of CD4+ with glucose and lipid metabolism. A: CD4+ was negatively correlated with FPG. B: CD4+ was negatively correlated with HbA1C. C: CD4+ was negatively correlated with FINS. D: CD4+ was negatively correlated with HOMA-IR. E: CD4+ was negatively correlated with TG. F: CD4+ was negatively correlated with TC. G: CD4+ was negatively correlated with HDL. H: CD4+ was negatively correlated with LDL.

Figure 6

Figure 6

ROC curve of CK-18, CD3+, and CD4+ for diagnosis of elderly T2DM patients with NAFLD.

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