Metabolic syndrome and the state of secondary immunodeficiency

The metabolic (MS) or insulin resistance syndrome includes a tetrade of signs: dyslipidemia, carbohydrate metabolism disorders presenting as type 2 diabetes mellitus (DM) or impaired glucose tolerance, arterial hypertension, and abdominal obesity. Arbitrary components are hyperuricaemia and microalbuminuria. The immune status of 24 patients with MS has been examined for the first time. Control groups consisted of 5 patients with type 2 DM without history of MS or chronic infections, 16 patients with chronic infections, and donors. Immunoglobulins A, M. and G were measured by Mancini’s method in gel; CD3, CD4, CD8, CD 16, and CD72 were evaluated using monoclonal antibodies (Sorbent); thyroid hormones were measured by enzyme immunoassay (Biorad). Thyroid diseases (autoimmune thyroiditis with nodular goiter or nodular goiter) were detected in 54%, chronic infectious diseases in 58.3%, and their combinations in 29.2% examined patients. Shifts in immune status were detected in MS patients without concomitant chronic infections and/or thyroid diseases: decreased counts of T lymphocytes and hyperfunction of В lymphocytes and dysimmunoglobulinemia with a significant increase in IgA and IgG levels. Presumably hyperstimulation of humoral immunity is the first stage of immune disorders in patients with MS. Combination of MS with thyroid diseases and/or chronic infections leads to inversion of the immune status with development of T helper, T suppressor, and NK insufficiency, В lymphocyte dysfunction, and low IgG level. Decreased count of NK cells in MS can be associated with increased risk of malignant diseases, including those of the thyroid.

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