[Reduced phagocytic capacity of circulating granulocytes in diabetes mellitus].
Impaired PMN function is regarded as a major cause for infectious complications in diabetes mellitus (d.m.). The aim of this study was to investigate the phagocytic PMN functions "ingestion" (IN) and "bacterial killing" (BK) with regard to metabolic control parameters and influences of variable glucose concentrations on these PMN functions in vitro. Our findings demonstrated a significant reduction of IN and BK in diabetic subjects compared to controls (p less than 0.001 resp.). The differences between type I and type II d.m. did not reach statistical significance. Linear regression analysis showed significantly negative correlations for fasting blood-glucose concentrations as well as glycosylated hemoglobin (HbA1) and IN (r = -0.34, p 0.03; r = -0.67, p = 0.001) and a highly positive for BK (r = 0.73, p = 0.0001). In vitro there was a significant decrease in IN and BK both in diabetic subjects and controls for glucose concentrations greater than 27.7 mmol/l (p = 0.01 resp.). These data clearly demonstrated impaired PMN ingestion and bacterial killing in diabetic patients, and the degree of PMN dysfunction is inversely related to the degree of metabolic control of diabetes. These findings suggest inhibitory effects of hyperglycemia on PMN functions, thus contributing at least partly to altered host defense in diabetes mellitus.
Marhoffer
W
W
Medizinische Klinik III und Poliklinik, Universität Giessen.
Stein
M
M
Mäser
E
E
Federlin
K
K
D001770:Blood Bactericidal Activity; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology*; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D009504:Neutrophils / Q000502:physiology*; D010587:Phagocytosis; D012044:Regression Analysis; D013211:Staphylococcus aureus
D006442:Glycated Hemoglobin
Eingeschränkte Phagozytoseleistung zirkulierender Granulozyten bei Diabetes mellitus.