Leukocyte Profiles Differ Between Type 1 and Type 2 Diabetes and Are Associated With Metabolic Phenotypes: Results From the German Diabetes Study (GDS)

• DOI: 10.2337/dc14-0316
• Publication Date: 2014-07-24T20:54:31Z
• Authors: Barbara Menart-Ho...; Ruth Rütter; Bettina Nowotny; Joachim Rosenbauer; Chrysi Koliaki; Sabine Kahl; Marie-Christine S...; Julia Szendroedi; Nanette C. Schloot; Michael Roden
• Keywords: Adult; Blood Glucose; Male; 0301 basic medicine; Adolescent; Middle Aged; Flow Cytometry; Body Mass Index; Immunophenotyping; 3. Good health; Leukocyte Count; Young Adult; 03 medical and health sciences; Diabetes Mellitus, Type 1; Phenotype; Diabetes Mellitus, Type 2; Germany; Glucose Clamp Technique; Humans; Female; Insulin Resistance; Aged

OBJECTIVE Altered immune reactivity precedes and accompanies type 1 and type 2 diabetes. We hypothesized that the metabolic phenotype relates to the systemic cellular immune status.

RESEARCH DESIGN AND METHODS A total of 194 metabolically well-controlled patients with type 1 diabetes (n = 62, mean diabetes duration 1.29 years) or type 2 diabetes (n = 132, 1.98 years) and 60 normoglycemic persons underwent blood sampling for automated white blood cell counting (WBC) and flow cytometry. Whole-body insulin sensitivity was measured with hyperinsulinemic-euglycemic clamp tests.

RESULTS Patients with type 2 diabetes had higher WBC counts than control subjects along with a higher percentage of T cells and activated T helper (Th) and cytotoxic T (Tc) cells but lower proportions of natural killer (NK) cells. In type 1 diabetes, the percentage of activated Th and Tc cells was also higher compared with control subjects, whereas the ratio of regulatory T (Treg) cells to activated Th cells was lower, suggesting diminished regulatory capacity. Parameters of glycemic control related positively to Treg cells only in type 2 diabetes. Upon age, sex, and body mass adjustments, insulin sensitivity correlated positively with monocytes, while circulating lipids correlated positively with T cell subsets in type 1 diabetes.

CONCLUSIONS Immune cell phenotypes showed distinct frequencies of occurrence in both diabetes types and associate with insulin sensitivity, glycemia, and lipidemia.