C-Reactive protein, Tumor Ncrosis Factor-alpha, interleukin-6 and cortisol in type 2 diabetes mellitus

ABSTRACT

Recently an abundance of evidence has emerged demonstrating a close link between immunity, inflammation, obesity, insulin resistance and type 2 diabetes mellitus. Activation of innate immunity with production of inflammatory markers was suggested to provide a new model for the pathogenesis of type 2 diabetes and the metabolic syndrome. This may result in new approaches for predicting and managing of type 2 diabetes and its complications. We evaluated the state of obesity and diabetes mellitus of thirty nine male type 2 diabetic patients and nineteen age-matched male healthy subjects as control. This evaluation was performed via assessment of the body mas index [BMI], fasting and postprandial [PP] blood glucose and insulin, insulin resistance and fasting C-peptide. Then we assessed the plasma levels of the most important inflammatory markers; C-reactive protein [C-RP], tumor necrosis factor alpha [TNF-alpha], interleukin-6 [IL-6] and the total leucocytic count as well as the stress hormone cortisol. Our results showed BMI above 30 for both patients and controls which indicated obesity of the two groups. Both fasting and PP glucose were 167.9 +/- 10.3 and 289.8 +/- 16 mg/dl respectively for patients and 96.4 +/- 1.96 and 108.47 +/- 4.6 rng/dl respectively for the control whish confirmed the diagnosis of diabetes mellitus. The C-RP was significantly higher in diabetics. Although the difference did not reach statistical significance fasting and PP-insulin, insulin resistance levels were higher in the diabetic patients compared to the control. Regarding the results of the acute phase reactants and the biornarkers for inflammation, we found a significant increase in C-RP, TNF-alpha, IL-6 and cortisol in the diabetic patients compared to the control. But no change could be detected in the total leucocytic count. This association between hyperglycemia and increased inflammatory markers may indicate a relationship between them. But the question which of them preceded and led to the other is still uncertain. Further studies with different approaches may be needed to solve this puzzle