title: [Effect of Roux-en-Y gastric bypass on the short-term immune function in patients with type 2 diabetes mellitus].
abstract: OBJECTIVE
  To investigate the effect of laparoscopic Roux-en-Y gastric bypass on the short-term immune function of type 2 diabetic patients and to explore the correlation between the immune regulatory effect and blood glucose control.
  
  
  METHODS
  Clinical data of 28 patients with type 2 diabetes mellitus who underwent laparoscopic Roux-en-Y gastric bypass surgery in our hospital during January 2014 to January 2015 were retrospectively collected. Fasting blood glucose (FBG), glycosylated hemoglobin (HbA1c), immunoglobulin (IgG, IgA, IgM), T lymphocytes CD3(+), killer T cells CD3(+)CD8(+), helper T cells CD3(+)CD4(+), natural killer(NK) cell subsets CD16(+),CD56(+) and B cell subsets CD19(+),CD45(+) levels were detected and compared between before and after surgery. Correlation of immunoglobulin and immune cell subsets with the level of FBG and HbA1c were examined.
  
  
  RESULTS
  After operation, FBG and HbA1c decreased significantly from (5.78±1.15) mmol/L to (14.21±1.89) mmol/L, and (9.96±0.97)% to (6.87±0.69)%, respectively (all P<0.05), and immunoglobulin (IgG, IgA, IgM) increased significantly [IgG: from(9.41±1.23) g/L to (12.74±1.61) g/L, IgM: from (1.71±0.22) g/L to (2.43±0.39) g/L, IgA: from (1.25±0.26) g/L to (1.97±0.23) g/L, all P<0.05]. Besides, T lymphocytes CD3(+), killer T cells CD3(+)CD8(+) and B cell subsets CD19(+)CD45(+) elevated significantly as well [T lymphocytes CD3(+): from (55.3±3.8)% to (67.6±4.6)%, killer T cells CD3(+)CD8(+): from (15.6±5.3)% to (28.7±4.2)%, B cell subsets CD19(+)CD45(+): from (8.4±3.7)% to (18.1±4.1)%, respectively, all P <0.05]. There was no significant difference in the expression of helper T cells CD3(+)CD4(+) and natural killer cell subsets CD16(+)CD56(+) between pre-operation and post-operation(all P>0.05). Levels of immunoglobulin (IgG, IgA, IgM), CD4(+)/CD8(+) ratio and B cell subsets were negatively correlated with HbA1c and FBG levels (IgG with FBG: r=-0.865, IgA with FBG: r=-0.887, IgM with FBG: r=-0.902, CD4(+)/CD8(+) with FBG: r=-0.956, CD19(+)CD45(+) with FBG: r=-0.834; IgG with HbA1C: r=-0.859, IgA with HbA1C: r=-0.957, IgM with HbA1C: r=-0.843, CD4(+)/CD8(+) with HbA1C: r=-0.912, CD19(+)CD45(+) and HbA1C: r=-0.885, all P<0.05), but the proportion of NK cells was not significantly correlated with HbA1c and FBG (P>0.05).
  
  
  CONCLUSIONS
  Laparoscopic Roux-en-Y gastric bypass has good effect on the immune function of patients with type 2 diabetes mellitus. Improvement of immune function is correlated with the control of FBG and HbA1c.
authors.forename: Lihai
authors.initials: L
authors.lastname: Zhang
authors.forename: Bin
authors.initials: B
authors.lastname: Xia
authors.forename: Jiao
authors.initials: J
authors.lastname: Wang
authors.forename: Xiaoping
authors.initials: X
authors.lastname: Lyu
authors.affiliation: Department of General Surgery, The First Affiliated Hospital, Jiamusi University, Heilongjiang Jiamusi 154003, China. Wys9906@163.com.
authors.forename: Yuesheng
authors.initials: Y
authors.lastname: Wang
authors.forename: Wenli
authors.initials: W
authors.lastname: Huang
authors.forename: Baihong
authors.initials: B
authors.lastname: Tan
authors.forename: Hong
authors.initials: H
authors.lastname: Deng
authors.forename: Yanbin
authors.initials: Y
authors.lastname: Yin
mesh_terms: D001786:Blood Glucose / Q000032:analysis; D003924:Diabetes Mellitus, Type 2 / Q000276:immunology* / Q000601:surgery; D015390:Gastric Bypass; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007136:Immunoglobulins / Q000097:blood; D010535:Laparoscopy; D016131:Lymphocyte Subsets / Q000276:immunology; D011184:Postoperative Period; D012189:Retrospective Studies
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007136:Immunoglobulins; C517652:hemoglobin A1c protein, human