Evaluation of TNF-α and IL-6 levels in obese and non-obese diabetics: Pre- and postinsulin effects

Abstract

Background:Type 2 diabetes (T2DM) mellitus is a serious implication of obesity. The effect of insulin therapy on levels of inflammatory markers among obese and non-obese diabetics has been inadequately studied.Aim:The study aimed to analyze the preinsulin and postinsulin levels of tumor necrosis factor α (TNF-α) and IL-6 in nonobese and obese T2DM patients.Materials and Methods:We assessed TNF-α and IL-6 levels in healthy controls (n=10) and diabetic patients (obese and nonobese; n=20 each) and analyzed the postinsulin effect on TNF-α and IL-6 levels after 24 and 48 weeks. TNF-α and IL-6 levels were also correlated with fasting plasma glucose of obese and nonobese diabetic patients after insulin therapy.Results:There is augmentation of TNF-α and IL-6 levels in diabetic patients and augmentation is more in obese than in nonobese diabetics. The obese group showed a significant decrease (P value<0.05) after 24 weeks of insulin therapy and an extremely significant decrease (P<0.001) in TNF-α and IL-6 levels after 48 weeks of therapy. The nonobese group showed an extremely significant decrease (P<0.001) in TNF-α and IL-6levels after 24 and 48 weeks both.Conclusion:There is augmented inflammation in diabetes and it is more in obese diabetics. Insulin therapy tends to counter this inflammation, but the response is delayed in obese diabetics.

CRP, but not TNF-α or IL-6, decreases after weight loss in patients with morbid obesity exposed to intensive weight reduction and balneological treatment

“…Significantly higher levels of TNF-α in the blood of patients with morbid obesity recorded in the current study are consistent with the results reported by Solá et al (2009) patients with morbid obesity and by Goyal et al (2012) in patients with severe obesity (BMI>30 kg/m 2 ) and type 2 diabetes. Cardillo et al (2006) studied 26 low-fat and 27 low-carbohydrate participants with a BMI of >35 kg/m 2 and found no differences in the concentration of TNF-α after 6 and 36 months of the observation period, independent of the diet regimen.…”

“…Increased levels of IL-6 were found in the blood of patients with morbid obesity (Solá et al, 2009), in patients with type 2 diabetes accompanied by obesity (Goyal et al, 2012), and in patients with type 2 diabetes with accompanying albuminuria (Czyżewska et al, 2012). An effect of weight loss on serum IL-6 in obese patients undergoing weight reduction was observed by OlszaneckaGlinianowicz et al (2011).…”

Combined metformin and insulin treatment reverses metabolically impaired omental adipogenesis and accumulation of 4-hydroxynonenal in obese diabetic patients

“…Metformin is frequently given to T2DM in combination with insulin [23]. Previous studies have shown that intensive insulin therapy reverses the decrease in adipocyte glucose transport activity in T2DM [24] and counters inflammation by decreasing levels of IL-6 and TNFα [25]. Insulin is commonly used in in vitro studies to induce adipogenesis, as it triggers a series of transcription factors that drive differentiation of pre-adipocytes into mature adipocytes including phosphorylation and activation of CREB [26] and PI 3-kinase [27].…”

Neck circumference as an anthropometric measure of obesity in diabetics

“…The trends in the prevalence of obesity documented over the last few decades in our country have been alarming, with morbid obesity affecting 5% of Indian population. [3] Insulin resistance is associated with visceral and subcutaneous fat content. [4]…”