Role of chronic low-grade inflammation in the development of the complications type 2 diabetes mellitus
AbstractAims: The aim of the present study was to investigate role of chronic low-grade inflammation in the development of the complications type 2 diabetes mellitus.
Methods: patients with type 2 diabetes mellitus evaluated glycemic and lipid profile, inflammatory cytocines, respiratory explosion and antioxidant activity of plasma using kinetic chemiluminescence, state of the retinal vessels and peripheral nerves (electromyography).
Results: we examined 50 patients with type 2 diabetes mellitus( 23 mеn, 27 women) with mean age of 60,45±6,88 years, mean duration of diabetes 5,24±3,58 years, mean BMI – 33,09±7,17 kg/m2, smoking history 12,43±14,54 years. All patients took oral glucose-lowering medicine(20 patients were treated with metformin, 27 patients – combination therapy sulfonylureas+ metformin, 3 patients with sulfonylureas). Average level tumor necrosis factor – 10,72±16,25 pg/ml (normal to 8,1), interleukin-6 – 2,96±1,79 pg/ml ( normal to 4,1), interleukin-1 in all patients was within normal range. Average level of C-reactive protein (CRP) was 4,6±5,99 g/l, recombinant fibrinogen 4,15±0,61 g/l (normal range 2,5– 4,78), leukocytes 7,27±2,22 109, ESR 13,49± 8,3 mm/h. Average HbA1c was 7,08±1%, total cholesterol 5,79± 0,98 mmol/l, triglycerides 2,36 ±1,72 mmol/l, LDL 3,54±1,02mmol/l, HDL 1,27±0,74 mmol/l. Evaluating respiratory explosion using kinetic chemiluminescence has not been showed significant differences between the character curve CL in healthy humans (n-100) and patients with diabetes (n-30). Antioxidant activity of plasma using kinetic chemiluminescence was significantly different in healthy people and patients with diabetesThese differences were characterized by slow recovery of the activity antioxidants (increasing the angle tg2). In addition, positive correlation was found between the angle tg2 and residual latency according to EMG, which may indicate the relationship of the defect antioxidant protection and the development of diabetic complications.
Conclusions: Chronic inflammation in patients with T2DM confirmed by high level TNF-alpha. However, we can not use IL-1 and respiratory explosion neutrophils. Also we discovered variations in the antioxidant status, which can affect the development of the complications of type 2 diabetes mellitus.
Keywords:type 2 diabetes mellitus, low-grade inflammation, oxidative stress