Tumor Necrosis factor - alpha, leptin and insulin resistance [peripheral sensitivity] in type 2 diabetes

ABSTRACT

Aim: Insulin resistance appears to play a pivotal role in the pathogenesis of type 2 diabetes and other chronic diseases including hypertension, cardiovascular disease and hyperlipidemia. Alterations in tumour necrosis factor-alpha [TNF-alpha] and leptin are suggested to be primary metabolic abnormalities leading to insulin resistance. The main aim of this work was to evaluate the serum level of TNF-alpha and leptin in type 2 diabetes mellitus and to correlate these levels with the degree of insulin resistance. Subjects and We studied 40 type 2 diabetic patients and 20 healthy controls. All patients and controls were subjected to history taking, clinical examination and laboratory studies including oral glucose tolerance curve with estimation of serum glucose and insulin, plasma TNF-alpha, serum leptin, lipid profile, serum uric acid and micro-albuminuria. Insulin sensitivity index [SI] was calculated. We found that serum TNF-alpha, serum leptin, total cholesterol, triglycerides, LDL-C, uric acid and micro-albumin were significantly higher in the diabetic group than in the healthy control subjects [P<0.05]. TNF-alpha and leptin were negatively correlated with the degree of insulin sensitivity. Conclusions: We concluded that both TNF-alpha and leptin may play an important role in insulin resistance syndrome in type 2 diabetes