BACKGROUND: Inflammation occurs in chronic diseases such as type 2 diabetes mellitus (DM). Insulin resistance and inflammation in type 2 DM with obesity can increase interleukin (IL)-6, causing an increase in hepcidin synthesis in the liver. Increased inflammation can exacerbate the course of type 2 DM. This study aims to prove that there are differences in the levels of hepcidin and IL-6 between obese and non-obese type 2 DM.METHODS: This cross-sectional study was conducted on 61 patients with type 2 DM, consist of 22 male and 39 female with an age of more than 40 years. Type 2 DM subjects were obtained from a doctor's diagnosis and were divided into obese and non-obese groups based on body mass index (BMI). Hepcidin and IL-6 levels were examined using the Enzyme-Linked Immunosorbent Assay (ELISA) principle. The data were analyzed using an independent t-test and Mann-Whitney test.RESULTS: The mean level of hepcidin in the obese with type 2 DM group was 25.32±11.54 ng/mL, and non-obese was 11.94±5.31 ng/mL. The median level of IL-6 in the obese with type 2 DM group was 11.9 (5-61) pg/mL, and non-obese 4.8 (1.5-9.8) pg/mL. There was a significant difference in hepcidin and IL-6 levels between the obese and non-obese groups (p=0.000).CONCLUSION: Hepcidin and IL-6 levels in the obese group with type 2 DM were higher than non-obese group.KEYWORDS: type 2 diabetes mellitus, obesity, hepcidin, interleukin-6
The distribution of fat tissue is related to the risk of metabolic diseases. Parathyroid Hormone (PTH) is an essential hormone for calcium homeostasis. According to several types of research, body fat affects PTH levels. Currently, Body Mass Index (BMI) is not the only parameter needed to identify the body fat distribution in accordance with chronic disease risks such as Waist Circumference (WC), Waist to Hip Ratio (WHR), and Waist to Height Ratio (WHtR). The study aimed to determine the relationship between body anthropometric measurement and PTH. A cross-sectional study was performed on a healthy population of 75 healthy female volunteers with a BMI ≥ 23 kg/m2. Waist circumference, WHR, WHtR, and BMI measurements were carried out and followed by the PTH fragment 1-84 (PTH1-84) test. Data were analyzed using the Spearman test with a significance of p<005. There was no significant correlation between PTH and WHR (r=0.057; p=0.628). There was weak correlation between PTH and BMI (r=0.268; p=0.020), WC (r=0.287; p=0.012) and WHtR (r=0.238; p=0.04). Body mass index, WC, and WHtR can be used as anthropometric parameters to determine PTH disorders
Graves' disease is caused by IgG antibodies that bind to the Thyroid Stimulating Hormone (TSH) receptor on the surfaceof the thyroid gland. These bonds drive the growth of stimulated thyroid follicular cells causing the glands to enlarge andincrease the production of thyroid hormones. Previous studies mention the association of HLA-B8 and HLA-DR3 withGraves' disease and the Cytotoxic T-lymphocyte-associated-4 (CTLA-4) gene on chromosome 2q33 as a result of reducingT-cell regulation, resulting in autoimmune disease. Autoimmune thyroid disease is often found together with otherautoimmune disorders (polyautoimmune). A 51-year-old male complained of dyspnea, yellowing of the body, and a lumpon the neck. One year ago, he was diagnosed with hyperthyroidism. Graves' disease was suspected due to a score of 22 forthe Wayne index, FT4 96.9 pmol/L, TSHs <0.01 μIU/mL, TRAb 10.8 IU/L, thyroid uptake test for toxic diffuse struma. Inaddition, the patient had atrial fibrillation and a thyroid storm with a Bruch Wartofsky index score of 65. Laboratoryexamination found normocytic normochromic anemia, thrombocytopenia, reticulocytosis, direct coomb test and autocontrol results positive one, SGOT 87 U/L, SGPT 59 U/L, alkali phosphatase 166 U/L, total bilirubin 38.13 mg/dL, directbilirubin 16.59 mg/dL, indirect bilirubin 21.54, LDH 318 U/L, establishing the diagnosis of Autoimmune Hemolytic Anemia(AIHA). Autoimmune hepatitis score: 15, so a diagnosis of probable autoimmune hepatitis was made.
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