Inflammatory Biomarkers of Cardiometabolic Risk in Obese Egyptian Type 2 Diabetics

Abstract

Inflammatory biomarkers provide a minimally invasive means for early detection and specific treatment of metabolic syndrome and related disorders. The objective of this work was to search for inflammatory biomarkers of cardiometabolic risk in obese type 2 diabetics. The study was performed on 165 persons attending the medical outpatient clinic of Ismailia General Hospital. Their mean age was (50.69 ± 10.15) years. They were divided into three groups. The control group was composed of 55 non-obese, non-diabetic healthy volunteers, 32 males and 23 females. Two study groups were included in this study: group 2 was composed of 55 obese, non-diabetic subjects, 25 males and 30 females matched for age and gender. All patients including the control were subjected to clinical history taking, a clinical examination for the measurement of body mass index (BMI). Investigations were carried out for fasting blood glucose, fasting serum insulin, insulin resistance (IR), the lipid profile, lipoprotein band lipoprotein phospholipase A2, and non-high-density lipoprotein cholesterol (non-HDL-C). Urea, albumin and creatinine analysis and liver function tests were performed, and a complete blood count (CBC) was taken. Hemoglobin A1C (HbA1C), serum high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were tested. There were statistically significant differences among the studied groups in terms of total cholesterol, non-HDL-C, high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), lipoprotein-associated phospholipase A2 and apolipoprotein B. The inflammatory biomarkers hs-CRP, IL-6 and TNF-α were significantly statistically increased in the study groups by (1.62 ± 0.99, 2.32 ± 1.11), (1.73 ± 1.14, 2.53 ± 1.34), and (1.87 ± 1.09, 2.17 ± 0.89) respectively, where p < 0.01. Significant positive correlation was found between Homeostatic Model Assessment (HOMA)-IR, hs-CRP and IL-6. There was a significant positive correlation between non-HDL and hs-CRP, IL-6 and TNF-α and triglycerides and hs-CRP. In conclusion, in this study, CRP, IL-6, and TNF-α were significantly elevated in obese Egyptian type 2 diabetics and were positively correlated with insulin resistance, non-HDL and triglycerides. These inflammatory biomarkers could help in the premature identification of obese type 2 diabetic patients at high cardiometabolic risk. Additionally, these biomarkers are critical for providing prognostics and the validity of future potential anti-inflammatory therapeutic modalities.

Study of interleukin-18 ( IL18 ) and high sensitive C - reactive protein ( CRP ) in type 2 diabetes ( T2D ) with or without obesity

“…Concerning renal functions, our study showed that diabetic groups had a significantly higher BUN and serum creatinine levels in comparison to non-diabetic groups. These conclusions are in agreement with the study of Barakat et al [23]. In their work, they compared various laboratory markers in three groups of patients including non-obese non-diabetic group, obese non-diabetic group and obese diabetic group.…”

Energy Intake and Plasma Adiponectin as Potential Determinants of Lipoprotein‐Associated Phospholipase A2 Activity: A Cross‐Sectional Study

“…Our results are in agreement with previous studies among overweight and obese subjects (Jackisch et al, ; Steffen et al, ), subjects with dyslipidemia (Tellis et al, ) and apparently healthy subjects with prehypertension (Kim et al, ). Higher Lp‐PLA 2 activity could be explained by higher Lp‐PLA 2 mass concurrently with higher levels of total and LDL‐cholesterol, triacylglycerols, and apolipoprotein B in obese compared to nonobese subjects and in subjects with dyslipidemia compared to subjects with normal lipid levels (Barakat et al, ; Jackisch et al, ; Tellis et al, ).…”

“…Higher Lp- 6.3 (5.3-8.4) 6.2 (5.4-7.5) 6.4 (5.7-6.9) 6.5 (5.7-7.7) 0.555 MUFA-to-SFA ratio 1.7 (1.5-2.1) 1.7 (1.5-1.9) 1.7 (1.4-1.9) 1. PLA 2 activity could be explained by higher Lp-PLA 2 mass concurrently with higher levels of total and LDL-cholesterol, triacylglycerols, and apolipoprotein B in obese compared to nonobese subjects and in subjects with dyslipidemia compared to subjects with normal lipid levels (Barakat et al, 2017;Jackisch et al, 2018;Tellis et al, 2013).…”

Interrelations Between Inflammatory and Oxidative Stress Biomarkers in Obese Women with Two Complications (Hypertension, Diabetes)

“…These correlations were found to be stronger in the presence of diabetes mellitus and hypertension, indicating an aggravation of inflammation and oxidative stress with obesityrelated complications. Leptin, IL-6, TNF-α, and CRP have all been shown to be elevated in metabolic syndrome, and generally are correlated with adiposity and high oxidative stress [10, 30,31]. Elevations in IL-6, TNF-α, CRP and leptin levels were detected among obese T2DM subjects showing a strong direct relationship with oxidant markers and a strong inverse relationship with antioxidant markers [10].…”

“…Associations between BMI, proinflammatory and oxidative biomarkers have been previously documented [30,32,33]. The clear relationship observed between inflammatory and oxidative marker concentrations and BMI shows the role of adipose tissue in initiating inflammation and oxidative stress [31].…”