title: Increased peripheral proinflammatory T helper subsets contribute to cardiovascular complications in diabetic patients.
abstract: BACKGROUND
  Coronary atherosclerotic heart disease (CHD) is one of the major concerns in type 2 diabetes (T2D). The systemic chronic inflammation has been postulated to bridge the increased risk of cardiovascular disease and T2D. We formulated that increased peripheral proinflammatory T helper subsets contributed to the development of cardiovascular complications in diabetic patients.
  
  
  METHODS
  The frequencies of peripheral total CD4+ T helper cells, proinflammatory Th1, Th17, and Th22 subsets were determined by flow cytometry in diabetic patients with or without CHD (n = 42 and 67, resp.).
  
  
  RESULTS
  Both peripheral frequencies and total numbers of Th1, Th17, and Th22 cells were further increased in diabetic patients with CHD. Logistic regression and categorical cross-table analysis further confirmed that increased proinflammatory Th subsets, especially Th22, were independent risk factors of cardiovascular complication in diabetes. Elevated Th subsets also correlated with increased CRP levels and the atherogenic index of plasma. Moreover, Th1 frequency and Th22 numbers demonstrated remarkable potential in predicting CHD in diabetes.
  
  
  CONCLUSIONS
  Increased peripheral proinflammatory T helper subsets act in concert and contribute to the increased prevalence of diabetic cardiovasculopathy. The recently identified Th22 cells might play an independent role in CHD and represent a novel proxy for cardiovascular risks in diabetes.
authors.affiliation: Department of Endocrinology, Qilu Hospital of Shandong University, Jinan 250012, China ; Institute of Endocrinology and Metabolism, Shandong University, Jinan 250012, China.
authors.forename: Ru-xing
authors.initials: RX
authors.lastname: Zhao
authors.affiliation: Department of Endocrinology, Qilu Hospital of Shandong University, Jinan 250012, China.
authors.forename: Wen-juan
authors.initials: WJ
authors.lastname: Li
authors.affiliation: Department of Endocrinology, Qilu Hospital of Shandong University, Jinan 250012, China.
authors.forename: Yi-ran
authors.initials: YR
authors.lastname: Lu
authors.affiliation: Department of Endocrinology, Qilu Hospital of Shandong University, Jinan 250012, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Qin
authors.affiliation: Department of Endocrinology, Qilu Hospital of Shandong University, Jinan 250012, China.
authors.forename: Chuan-long
authors.initials: CL
authors.lastname: Wu
authors.affiliation: Department of Endocrinology, Qilu Hospital of Shandong University, Jinan 250012, China.
authors.forename: Meng
authors.initials: M
authors.lastname: Tian
authors.affiliation: Department of Endocrinology, Qilu Hospital of Shandong University, Jinan 250012, China.
authors.forename: Tian-yi
authors.initials: TY
authors.lastname: He
authors.affiliation: Centre for Transplant and Renal Research, Westmead Millennium Institute, The University of Sydney at Westmead Hospital, Westmead, NSW, Australia.
authors.forename: Shou-nan
authors.initials: SN
authors.lastname: Yi
authors.affiliation: Key Laboratory of Cardiovascular Remodeling and Function Research, Research Center for Cell Therapy, Qilu Hospital of Shandong University, Jinan 250000, China.
authors.forename: Dong-qi
authors.initials: DQ
authors.lastname: Tang
authors.affiliation: Department of Endocrinology, Qilu Hospital of Shandong University, Jinan 250012, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Sun
authors.affiliation: Department of Endocrinology, Qilu Hospital of Shandong University, Jinan 250012, China ; Institute of Endocrinology and Metabolism, Shandong University, Jinan 250012, China.
authors.forename: Li
authors.initials: L
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D003324:Coronary Artery Disease / Q000276:immunology* / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000276:immunology* / Q000378:metabolism; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D008297:Male; D008875:Middle Aged; D006377:T-Lymphocytes, Helper-Inducer / Q000276:immunology / Q000378:metabolism*; D018417:Th1 Cells / Q000378:metabolism; D058504:Th17 Cells / Q000378:metabolism