Biomarker of systemic inflammation in women with arterial hypertension and obesity, depending on the presence of type 2 diabetes.

PHD N.M. Kyrychenko

Sumy State University

Type 2 diabetes mellitus and related complications are serious global public health problem. The presence of chronic systemic inflammation associated with an increase body weight and changes in the functions and activity of adipose tissue can cause the development of disorders in the regulation of glucose metabolism and in the future lead to T2DM.

The purpose of the study was to determine the biomarkers of systemic inflammation in women with hypertension and obesity, depending on the presence or absence of type 2 diabetes.

Materials and methods. 70 patients aged 40 to 60 years were examined. Patients were divided into groups depending on the presence or absence of T2DM. Statistical data processing was performed using Statistica for Windows 6.0. Results. In women with III degree obesity, even in the absence of T2DM, higher levels of insulinemia, HOMA-IR and glycosylated hemoglobin were determined compared to patients with I and II degree of obesity. In patients with type 2 diabetes and grade III obesity, significantly higher levels of systemic inflammation biomarkers in the blood were recorded. Conclusions. Women with III degree obesity have significantly higher levels of glycemia and insulinemia compared with patients with I and II degree of obesity even in the absence of type 2 diabetes. The presence of type 2 diabetes in women is associated with significantly higher levels of systemic inflammation biomarkers in the blood.

Key Words: obesity, diabetes mellitus, inflammation, markers, arterial hypertension, women.


For citing:

1. Кириченко, Н.М. Рівні біомаркерів системного запалення у жінок з артеріальною гіпертензією та ожирінням в залежності від наявності супутнього цукрового діабету 2 типу // Східноєвропейський журнал внутрішньої та сімейної медицини. – 2020. – № 1. – С. 43-47. doi: 10.15407/internalmed2020.01.043

2. Kyrychenko NM. [Biomarker of systemic inflammation in women with arterial hypertension and obesity, depending on the presence of type 2 diabetes]. Shidnoevr. z. vnutr. simejnoi med. 2020;1:43-47. doi: 10.15407/internalmed2020.01.043. Ukrainian.


1. Grossmann V, Schmitt V, Zeller T, Panova-Noeva M, Schulz A, Laubert-Reh D, Juenger C, Schnabel R, Abt T, Laskowski R, Wiltink J, Schulz E, Blankenberg S, Lackner K, Münzel T, Wild P. Profile of the Immune and Inflammatory Response in Individuals With Prediabetes and Type 2 Diabetes. Diabetes Care. 2015;38(7):1356-1364.

2. Velloso L, Eizirik D, Cnop M. Type 2 diabetes mellitus – an autoimmune disease? Nature Reviews Endocrinology. 2013;9(12):750-755.

3. Centers for Disease Control and Prevention. Prevalence of overweight and obesity among adults with diagnosed diabetes, 1988-2002 and 2005-2017. MMWR Morb Mortal Wkly Rep. 20018;53:1066-1068.

4. Blüher M, Mantzoros C. From leptin to other adipokines in health and disease: Facts and expectations at the beginning of the 21st century. Metabolism. 2015;64(1):131-145.

5. Fasshauer M, Blüher M. Adipokines in health and disease. Trends in Pharmacological Sciences. 2015;36(7):461-470.

6. Garvey W, Van Gaal L, Leiter L, Vijapurkar U, List J, Cuddihy R, Ren J, Davies M. Effects of canagliflozin versus glimepiride on adipokines and inflammatory biomarkers in type 2 diabetes. Metabolism. 2018;85:32-37.

7. Diagnosis and Classification of Diabetes Mellitus. Diabetes Care. 2013;37(Supplement_1):S81-S90.

8. Donath M, Shoelson S. Type 2 diabetes as an inflammatory disease. Nature Reviews Immunology. 2011;11(2):98-107.

9. Herder C, Carstensen M, Ouwens D. Anti-inflammatory cytokines and risk of type 2 diabetes. Diabetes, Obesity and Metabolism. 2013;15(s3):39-50.

10. Williams B, Mancia G, Spiering W, Rosei EA, Azizi M, Burnier M, Clement DL, Coca A, Simone G, Dominiczak A, Kahan T, Mahfoud F, Redon J, Ruilope L, Zanchetti A, Kerins M, Kjeldsen SE, Kreutz R, Laurent S, Lip GYH, McManus R, Narkiewicz K, Ruschitzka F, Schmieder RE, Shlyakhto E, Tsioufis C, Aboyans V, Desormais I. 2018 ESC/ESH Guidelines for the management of arterial hypertension. European Heart Journal. 2018:39(33);3021-3104.

11. Esser N, Legrand-Poels S, Piette J, Scheen A, Paquot N. Inflammation as a link between obesity, metabolic syndrome and type 2 diabetes. Diabetes Research and Clinical Practice. 2014;105(2):141-150.

12. Donath M, Shoelson S. Type 2 diabetes as an inflammatory disease. Nature Reviews Immunology. 2011;11(2):98-107.

13. Chawla A, Nguyen K, Goh Y. Macrophage-mediated inflammation in metabolic disease. Nature Reviews Immunology. 2011;11(11):738-749.

14. Ouchi N, Parker J, Lugus J, Walsh K. Adipokines in inflammation and metabolic disease. Nature Reviews Immunology. 2011;11(2):85-97.

15. Belalcazar L, Haffner S, Lang W, Hoogeveen R, Rushing J, Schwenke D, Tracy R, Pi-Sunyer F, Kriska A, Ballantyne and the Look AHEAD Actio C. Lifestyle intervention and/or statins for the reduction of C-reactive protein in type 2 diabetes: From the look AHEAD study. Obesity. 2013;21(5):944-950.

16. Phillips C, Perry I. Does Inflammation Determine Metabolic Health Status in Obese and Nonobese Adults?. The Journal of Clinical Endocrinology & Metabolism. 2013;98(10):E1610-E1619.

17. Duncan B, Schmidt M, Pankow J, Ballantyne C, Couper D, Vigo A, Hoogeveen R, Folsom A, Heiss G. Low-Grade Systemic Inflammation and the Development of Type 2 Diabetes: The Atherosclerosis Risk in Communities Study. Diabetes. 2003;52(7):1799-1805.

18. Spranger J, Kroke A, Mohlig M, Hoffmann K, Bergmann M, Ristow M, Boeing H, Pfeiffer A. Inflammatory Cytokines and the Risk to Develop Type 2 Diabetes: Results of the Prospective Population-Based European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam Study. Diabetes. 2003;52(3):812-817.

19. Herder C, Baumert J, Thorand B, Koenig W, de Jager W, Meisinger C, Illig T, Martin S, Kolb H. Chemokines as risk factors for type 2 diabetes: results from the MONICA/KORA Augsburg study, 1984-2002. Diabetologia. 2006;49(5):921-929.

20. Wang X, Bao W, Liu J, OuYang Y, Wang D, Rong S, Xiao X, Shan Z, Zhang Y, Yao P, Liu L. Inflammatory Markers and Risk of Type 2 Diabetes: A systematic review and meta-analysis. Diabetes Care. 2012;36(1):166-175.

21. Jager A, van Hinsbergh V, Kostense P, Emeis J, Yudkin J, Nijpels G, Dekker J, Heine R, Bouter L, Stehouwer C. von Willebrand Factor, C-Reactive Protein, and 5-Year Mortality in Diabetic and Nondiabetic Subjects. Arteriosclerosis, Thrombosis, and Vascular Biology. 1999;19(12):3071-3078.

22. Hotamisligil G, Arner P, Caro J, Atkinson R, Spiegelman B. Increased adipose tissue expression of tumor necrosis factor-alpha in human obesity and insulin resistance. Journal of Clinical Investigation. 1995;95(5):2409-2415.

23. O’Rourke R, White A, Metcalf M, Olivas A, Mitra P, Larison W, Cheang E, Varlamov O, Corless C, Roberts C, Marks D. Hypoxia-induced inflammatory cytokine secretion in human adipose tissue stromovascular cells. Diabetologia. 2011;54(6):1480-1490.

24. Skurk T, Alberti-Huber C, Herder C, Hauner H. Relationship between Adipocyte Size and Adipokine Expression and Secretion. The Journal of Clinical Endocrinology & Metabolism. 2007;92(3):1023-1033.

25. Cancello R, Henegar C, Viguerie N, Taleb S, Poitou C, Rouault C, Coupaye M, Pelloux V, Hugol D, Bouillot J, Bouloumie A, Barbatelli G, Cinti S, Svensson P, Barsh G, Zucker J, Basdevant A, Langin D, Clement K. Reduction of Macrophage Infiltration and Chemoattractant Gene Expression Changes in White Adipose Tissue of Morbidly Obese Subjects After Surgery-Induced Weight Loss. Diabetes. 2005;54(8):2277-2286.

26. Bruun J, Helge J, Richelsen B, Stallknecht B. Diet and exercise reduce low-grade inflammation and macrophage infiltration in adipose tissue but not in skeletal muscle in severely obese subjects. American Journal of Physiology-Endocrinology and Metabolism. 2006;290(5):E961-E967.

27. Wentworth J, Naselli G, Brown W, Doyle L, Phipson B, Smyth G, Wabitsch M, O’Brien P, Harrison L. Pro-Inflammatory CD11c+CD206+ Adipose Tissue Macrophages Are Associated with Insulin Resistance in Human Obesity. Diabetes. 2010;59(7):1648-1656.

28. Feuerer M, Herrero L, Cipolletta D, Naaz A, Wong J, Nayer A, Lee J, Goldfine A, Benoist C, Shoelson S, Mathis D. Lean, but not obese, fat is enriched for a unique population of regulatory T cells that affect metabolic parameters. Nature Medicine. 2009;15(8):930-939.

29. Nishimura S, Manabe I, Nagasaki M, Eto K, Yamashita H, Ohsugi M, Otsu M, Hara K, Ueki K, Sugiura S, Yoshimura K, Kadowaki T, Nagai R. CD8+ effector T cells contribute to macrophage recruitment and adipose tissue inflammation in obesity. Nature Medicine. 2009;15(8):914-920.

30. Winer S, Chan Y, Paltser G, Truong D, Tsui H, Bahrami J, Dorfman R, Wang Y, Zielenski J, Mastronardi F, Maezawa Y, Drucker D, Engleman E, Winer D, Dosch H. Normalization of obesity-associated insulin resistance through immunotherapy. Nature Medicine. 2009;15(8):921-929.

31. Deiuliis J, Shah Z, Shah N, Needleman B, Mikami D, Narula V, Perry K, Hazey J, Kampfrath T, Kollengode M, Sun Q, Satoskar A, Lumeng C, Moffatt-Bruce S, Rajagopalan S. Visceral Adipose Inflammation in Obesity Is Associated with Critical Alterations in Tregulatory Cell Numbers. PLoS ONE. 2011;6(1):e16376.

32. Jagannathan-Bogdan M, McDonnell M, Shin H, Rehman Q, Hasturk H, Apovian C, Nikolajczyk B. Elevated Proinflammatory Cytokine Production by a Skewed T Cell Compartment Requires Monocytes and Promotes Inflammation in Type 2 Diabetes. The Journal of Immunology. 2010;186(2):1162-1172.