Tumor necrosis factor alpha levels in Egyptian patients with diabetes mellitus

ABSTRACT

There is increasing evidences of implicating tumor necrosis factor alpha [TNF-alpha] in the pathogensis of type 2 diabetes mellitus [T2DM]. The purpose of this study was to evaluate the potential association between serum [TNF-alpha] and T2DM, its relationship to different metabolic complications and to oral antidiabetic drugs. Eighty type 2 diabetic patients [40-70 years] and 20 age, sex and body mass index [BMI] matched controls were studied. Full history, clinical examination and anthropometric measurements were taken, TNF-alpha levels using a high sensitive enzyme- linked immuno- sorbent assay were measured in each of them, in addition to fasting and 2 hours postprandial blood sugar, triglycerids and cholesterol levels. Fundus examination, electrocardiogram and Doppler ultrasoundd for were also done. The mean TNF-alpha concentration in diabetic patients was significantly increased at 14.9 +/- 8.9 Pg/ml compared to 6.5 +/- 3.5 pg/ml in controls. No difference was noted between men and women. Serum levels of TNF-alpha showed significant positive correlation with the duration of diabetes [P<0.01], while there was no correlation with BMI. TNF-alpha levels showed no significant changes with complications. However, patients treated with gliclazide and roseglitazones had lower TNF-alpha concenntration [14.4 and 13.4 pg/ml respectively] compared with patients treated with glibenclamide [16.4 pg/ml]. In The association between high TNF-alpha levels and T2DM found in this study raise the relation between them. It could be a result due to activation of immune system in T2DM. Our data support interaction between metabolic and inflammatory pathways occurring in diabetes mellitus, and the possibility for a mechanism of antidiabetic drugs in cytokine levels in improving hyperglycemia