Endocrine Abstracts

One of the leading roles in the mechanisms of type 2 diabetes mellitus (T2DM) belongs to immunopathological link of pathogenesis, which determines the development rate and severity of its specific complications, in particular, non-alcoholic fatty liver disease (NAFLD).

The purpose: To examine the contents of cytokines and major lymphocyte subsets in patients with T2DM and NAFLD.

Description of methods: We observed 118 patients, including 64 patients with T2DM and NAFLD, 26 patients with T2DM and 28 patients with NAFLD. The control group consisted of 25 apparently healthy individuals.

Results: Identified changes in the level of cytokines and lymphocyte subpopulation composition in combination of T2DM with NAFLD can be used both for diagnosis and for predicting adverse development of this disease, in particular the development of the inflammatory response in the liver (increased level of IL1β), intensity and orientation of immunopathological reactions (increased IFNγ level, decreased IL4 level, and changed NK cells level), the intensity of proliferation of connective tissue and fibrosis formation (increased IL10 level).

Conclusions: In patients with T2DM, NAFLD or a combination of these abnormalities are observed changes in cytokine status, reflecting the intensity of the inflammatory immune responses, their direction and possible forecast of liver fibrosis. Increased blood levels of IL1β, IL17, and IFNγ indicate the presence of high inflammatory and immunopathological reactions in patients with T2DM and NAFLD. Imbalance is observed in the composition of lymphocyte subpopulations, manifested by decries of CD8+ and CD16+ lymphocytes at a relatively stable level of T helper (CD4+) lymphocytes and increased content of CD20+ lymphocytes which develops against the background of increased level of circulating immune complexes. In patients with NAFLD and T2DM increased apoptotic preparedness of lymphocytes were revealed, which manifests as increased content of CD95+ cells in the blood.