Correlation research of blood glucose with inflammatory factors and immune function in patients with severe burn

Abstract

Objective To investigate the correlation between blood glucose levels, inflammatory factors and immune function of patients who suffered from severe burns. Methods A sample size of 96 severe burns patients were chosen at Department of Burns and Plastic Surgery, First Affiliated Hospital of Chengdu Medical College over the period of January 2012 to December 2017, to serve as the experimental group; while 60 healthy volunteers after physical examination from First Affiliated Hospital of Chengdu Medical College served as control group. The fasting blood glucose (FPG) level, inflammatory factors, and T-lmphocytes levels for both two groups were studied, and the differences between FPG, inflammatory factors, and T-lymphocytes levels were compared between the two groups. The patients in the experimental group were divided into normal blood glucose group (FPG <7.0 mmol/L) with 17 cases and high blood glucose group (FPG≥7.0 mmol/L) with 79 cases according to the FPG concentration. Data were compared with t test. Results The experimental group had FPG (11.39±2.28) mmol/L, C-reactive protein(CRP) was (39.67±4.15) mg/L, tumor necrosis factor-α(TNF) was (108.12±6.49) ng/L, interleukin(IL)-6 was (139.77±7.43) ng/L, IL-8 (91.56±4.91) ng/L, higher than the control group [FPG(5.07±1.15) mmol/L, CRP was (5.91±0.76) mg/L, TNF-α was (12.94±1.69) ng/L, IL-6 was (14.11±3.93) ng/L, IL-8 was (17.22±2.89) ng/L], the differences were statistically significant (t=5.365, 4.365, 11.912, 9.834, 6.139; with P values below 0.05); in the experimental group, the immune index, CD4+ T-lymphocytes level was (29.77±4.12)% and CD4+ /CD8+ was 0.91±0.24, which were lower than those of the control group (41.89±5.36)% and 1.59±0.37. The CD8+ T-lymphocytes level in the experimental group was (32.69± 4.73)%, which was higher than the control group [(25.83±3.52)%], the differences were statistically significant (t=3.931, 2.433, 2.696; with P values below 0.05). In the experimental group, plasma CRP was (45.19±5.45) mg/L, TNF-α was (121.81±5.43) ng/L, IL-6 was (153.31±5.57) ng/L, IL-8 was (106.56±5.65) ng/L and CD8+ T-lymphocytes was (35.46±4.11)% in the high blood glucose group, which were higher than normal blood glucose group [CRP (36.67±3.45) mg/L, TNF-α (91.58±4.93) ng/L, IL-6 (114.65±6.33) ng/L, IL-8 (79.62±3.74) ng/L, CD8+ T-lymphocytes level (28.62±4.03)%], the differences were statistically significant (t=2.341, 2.894, 4.167, 3.018, 2.763; with P values below 0.05); CD4+ T-lymphocytes level (28.89±3.79)% and CD4+ /CD8+ (0.82±0.37) were lower than those in the normal blood glucose group [(33.47±4.98)%, 1.17±0.52], and the differences were statistically significant (t=2.158, 2.247; with P values below 0.05). There were positive correlation between FPG and CRP, TNF-α, IL-6, IL-10 and CD8+ T-lymphocytes level (r=0.651, 0.571, 0.781, 0.425, 0.543; with P values below 0.05), which were negatively correlated with CD4+ T-lymphocytes level and CD4+ /CD8+ (r=-0.636, -0.519; with P values below 0.05). Conclusion Severely burned patients will experience stress reaction, stress hyperglycemia and significant changes in the body′s inflammatory factors and immune function, blood glucose and inflammatory factors and immune levels have a significant correlation, the higher the blood sugar, the more pronounced the inflammatory reaction is, the lower the immune function is. Key words: Burns; Blood glucose; Tumor necrosis factor-alpha; Interleukin-6; Interleukin-8; T-lymphocytes subset