Inflammatory cytokine and plasma C-reactive protein response to ketoacidosis in adults with type 1 diabetes: Egyptian multicenter study

Abstract

Background In adults with diabetic ketoacidosis (DKA), high plasma levels of C-reactive protein (CRP) and inflammatory cytokines such as interleukin-6 (IL-6) were reported to be sensitive markers of infection. However, elevation of both CRP and the pro-inflammatory cytokines which regulate CRP are probable without infection and may act as indicator of systemic inflammatory response (SIR). So, we wanted to determine if increased plasma CRP levels occur in young patients with severe DKA who do not have clinical evidence of infection and to relate observed changes in CRP level to the pro-inflammatory cytokine levels. Results Upon admission of 30 DKA patients with age ranging from 17 to 40 years, we found significant elevation of CRP (P = 0.001) and IL-6 (P = 0.001) in DKA patients than control group. After resolution of DKA, there was significant reduction in CRP and IL-6 compared to before DKA correction (P value = 0.054 and 0.001), respectively. There was a significant negative correlation between CRP after correction of DKA and RBCs (P = 0.042), and serum K (P = 0.021) and between CRP prior to DKA correction and PH (P = 0.025). Conclusions Patients with DKA without infection had increased levels of CRP and inflammatory cytokines. Intensive insulin therapy has a powerful anti-inflammatory effect that, at the time of DKA improvement, can normalize levels of CRP and inflammatory cytokines, and this beneficial effect is greater for IL-6 than CRP.

Effects of Andrographis paniculata Leaf Extract on C-Reactive Protein and Serum Ferritin in Lipopolysaccharide-Induced Sepsis Model Rat

“…24 Factors that influence the increase in CRP levels during inflammation are increases in proinflammatory cytokines such as IL-6, TNF-a, IL-1ß and NF-kB. 25 This endotoxin will increase pro-inflammatory mediators such as TNF-a, IL-6, IL-1, and IL-17 to activate macrophages, then macrophages will damage tissue resulting in inflammation. 25 Acute inflammation can cause sepsis precipitated by an infectious agent.…”

“…25 This endotoxin will increase pro-inflammatory mediators such as TNF-a, IL-6, IL-1, and IL-17 to activate macrophages, then macrophages will damage tissue resulting in inflammation. 25 Acute inflammation can cause sepsis precipitated by an infectious agent. 26 Burgos et.…”

Evaluation of some biochemical markers in relation to COVID-19 mRNA vaccine

“…It during 6 hours of inflammatory process stimulation, substantial quantities are ejected [4,23]. The overproduction of inflammatory cytokines may be responsible for the increased CRP values [24]. Although cytokines work to combat pathogens, lung tissue can be harmed when the immune system is overactive [25].…”

Case report: catamenial hyperglycemia: the trigger of recurrent DKA in a female patient with three-year follow-up

“…DKA is a severe side effect of a metabolic condition that is characterized by hyperglycemia, and metabolic acidosis ( 2 ). It is associated with a severe inflammatory condition characterized by an elevation in proinflammatory cytokines (tumor necrosis factor-α and interleukin-β, -6, and -8), C-reactive protein, reactive oxygen species, and lipid peroxidation ( 3 ). Additionally, cardiovascular risk factors such as plasminogen activator inhibitor-1 and free fatty acids are elevated, even in the absence of a serious infection or cardiovascular pathology.…”