IMMUNOLOGICAL RISK FACTORS OF DEATH IN DIABETES

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Abstract

Objective: we investigated immunological risk factors for death in patients with diabetes mellitus (DM).

Material and Methods: In a prospective cohort study included 337 patients with impaired glucose metabolism (36 – with impaired fasting glucose or impaired glucose tolerance, 80 – with type 1 diabetes, 194 – with type 2 diabetes, 27 – with diabetes due to chronic pancreatitis). Average follow-up was 11,2 ± 4,8 years. The level of antibodies, circulating immune complexes, the presence of antibodies to islet cells; number of CD3+, CD4+, CD8+ lymphocytes and the proliferation activity of the lymphocytes in response to PHA, insulin.

Results: During the follow-up period 115 patients died. The most common cause of death in patients with diabetes was cardiovascular diseases and cancer. The levels of immunoglobulins and circulating complexes are not informative for prognosis. Lack of autoimmune reactions and decreased lymphocyte proliferation in response to PHA are the risk factorsfor death in type 1 diabetes. Autoimmune response to insulin, suppressed by prostaglandin synthesizing cellshas a protective effectin type 2 diabetes.

Conclusion: Cell-mediated immunity to insulin, islet cell antibodies, reduction of proliferative activity in response to the PHA are unfavorable prognostic factors in patients with impaired carbohydrate metabolism.

About the authors

N. S. Asfandiyarova

Ryazan State Medical University

Author for correspondence.
Email: n.asfandiyarova2010@yandex.ru

MD (Medicine), Senior Researcher, assistant professor, allergist-immunologist doctor of higher category

390044, Ryazan, ul. Kosticheva, 7–148

Russian Federation

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