The Inflammatory Markers, Interleukin-6 and C-Reactive Protein in Type 2 Diabetes Mellitus.

number: 
1859
إنجليزية
Degree: 
Imprint: 
Medicine
Author: 
Zainab Abd AL- Wahed Naji
Supervisor: 
Dr.Firyal Hassan Al-Obydi
year: 
2007

Abstract:

Type 2 diabetes mellitus (DM) is suddenly increasing in incidence, and is associated with increase risk for cardiovascular disease, because of the resultant macrovascular and microvascular injury. Although the main physiological abnormalities are insulin resistance and impaired insulin secretion, the specific determinants of these metabolic defects remain uncertain. The experimental evidences suggest that inflammation may play an intermediary role in pathogenesis, there by linking diabetes with a number of commonly coexisting conditions thought to originate through inflammatory mechanisms, and also suggest that interleukin 6 (IL-6) and C-reactive protein (C-RP), are two sensitive physiological markers of inflammation, that associated with hyperglycemia, insulin resistance, and type 2 DM. Indeed, it recently has been postulated that type 2 DM may represent a disease of the innate immune system, a hypothesis of particular interest because both of these inflammatory biomarkers also are known to predict the development of cardiovascular disease in otherwise healthy populations.Interleukin 6, a major proinflammatory cytokine, is produced in a variety of tissues, including activated leukocytes, adipocytes, and endothelial cells. C-reactive protein is the principal mediator of the acute phase response and is primarily derived via IL-6–dependent hepatic biosynthesis. Several studies have demonstrated elevated levels of IL-6 and C-RP among individuals both with features of the insulin resistance syndrome and type 2 DM. The present study includes measurement of interleukin 6, C-reactive protein, serum glucose, urea, creatinine, lipid profile and glycated hemoglobine (HbA1c) in 150 patients with type2 DM (78 males and 72 females), Who were on oral hypoglycemic agents, in addition to 100 healthy controls (56 males and 44 females). Depending on the HbA1c diabetic patients were divided into 4 main groups [(<7%), (7-7.9%), (8-8.9%) and (=>9%)] according to National Health for services,(British, 2003). Diabetic patients were also divided in to 3 groups depending on their Body Mass Index, [(normal 20-24.9 kg/m2), (overweight 25-28.9 kg/m2) and (obese 29-34.9 kg/m2)] according to National Institutes of Health Consensus Development Panel, 1995. After statistical analysis for the data obtained, the following were observed:- The study shows significant elevation in serum Interleukin-6 level for Both HbA1c and BMI type 2 diabetics groups in comparison to healthy controls. Weak correlation between Interleukin-6 and other serum parameters included in the present study. Significant increase in C-reactive protein level for the type 2 diabetics groups in all serum parameters present in this study in comparison to healthy controls. There was a significant association between glycemic control and reduction in serum lipid profile level. Good glycemic control in association with significant reduction in level of HbA1c and Body Mass Index. In conclusion, the result of present study suggest and support a possible role for inflammation in the pathogenesis of type 2DM, in which elevated levels of C-reactive protein and Interleukin-6 predict the development of type 2 Diabetes Mellitus.