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.

https://dx.doi.org/10.15407/internalmed2020.01.043

Download.PDF(ukr)

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.

References

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. http://dx.doi.org/10.2337/dc14-3008
https://doi.org/10.2337/dc14-3008

2. Velloso L, Eizirik D, Cnop M. Type 2 diabetes mellitus – an autoimmune disease? Nature Reviews Endocrinology. 2013;9(12):750-755. http://dx.doi.org/10.1038/nrendo.2013.131
https://doi.org/10.1038/nrendo.2013.131

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. http://dx.doi.org/10.1016/j.metabol.2014.10.016
https://doi.org/10.1016/j.metabol.2014.10.016

5. Fasshauer M, Blüher M. Adipokines in health and disease. Trends in Pharmacological Sciences. 2015;36(7):461-470. http://dx.doi.org/10.1016/j.tips.2015.04.014
https://doi.org/10.1016/j.tips.2015.04.014

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. http://dx.doi.org/10.1016/j.metabol.2018.02.002
https://doi.org/10.1016/j.metabol.2018.02.002

7. Diagnosis and Classification of Diabetes Mellitus. Diabetes Care. 2013;37(Supplement_1):S81-S90. http://dx.doi.org/10.2337/dc14-s081
https://doi.org/10.2337/dc14-S081

8. Donath M, Shoelson S. Type 2 diabetes as an inflammatory disease. Nature Reviews Immunology. 2011;11(2):98-107. http://dx.doi.org/10.1038/nri2925
https://doi.org/10.1038/nri2925

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. http://dx.doi.org/10.1111/dom.12155
https://doi.org/10.1111/dom.12155

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. https://doi.org/10.1093/eurheartj/ehy339
https://doi.org/10.1093/eurheartj/ehy339

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. http://dx.doi.org/10.1016/j.diabres.2014.04.006
https://doi.org/10.1016/j.diabres.2014.04.006

12. Donath M, Shoelson S. Type 2 diabetes as an inflammatory disease. Nature Reviews Immunology. 2011;11(2):98-107. http://dx.doi.org/10.1038/nri2925
https://doi.org/10.1038/nri2925

13. Chawla A, Nguyen K, Goh Y. Macrophage-mediated inflammation in metabolic disease. Nature Reviews Immunology. 2011;11(11):738-749. http://dx.doi.org/10.1038/nri3071
https://doi.org/10.1038/nri3071

14. Ouchi N, Parker J, Lugus J, Walsh K. Adipokines in inflammation and metabolic disease. Nature Reviews Immunology. 2011;11(2):85-97. http://dx.doi.org/10.1038/nri2921
https://doi.org/10.1038/nri2921

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. http://dx.doi.org/10.1002/oby.20431
https://doi.org/10.1002/oby.20431

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. http://dx.doi.org/10.1210/jc.2013-2038
https://doi.org/10.1210/jc.2013-2038

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. http://dx.doi.org/10.2337/diabetes.52.7.1799
https://doi.org/10.2337/diabetes.52.7.1799

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. http://dx.doi.org/10.2337/diabetes.52.3.812
https://doi.org/10.2337/diabetes.52.3.812

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. http://dx.doi.org/10.1007/s00125-006-0190-y
https://doi.org/10.1007/s00125-006-0190-y

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. http://dx.doi.org/10.2337/dc12-0702
https://doi.org/10.2337/dc12-0702

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. http://dx.doi.org/10.1161/01.atv.19.12.3071
https://doi.org/10.1161/01.ATV.19.12.3071

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. http://dx.doi.org/10.1172/jci117936
https://doi.org/10.1172/JCI117936

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. http://dx.doi.org/10.1007/s00125-011-2103-y
https://doi.org/10.1007/s00125-011-2103-y

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. http://dx.doi.org/10.1210/jc.2006-1055
https://doi.org/10.1210/jc.2006-1055

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. http://dx.doi.org/10.2337/diabetes.54.8.2277
https://doi.org/10.2337/diabetes.54.8.2277

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. http://dx.doi.org/10.1152/ajpendo.00506.2005
https://doi.org/10.1152/ajpendo.00506.2005

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. http://dx.doi.org/10.2337/db09-0287
https://doi.org/10.2337/db09-0287

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. http://dx.doi.org/10.1038/nm.2002
https://doi.org/10.1038/nm.2002

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. http://dx.doi.org/10.1038/nm.1964
https://doi.org/10.1038/nm.1964

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. http://dx.doi.org/10.1038/nm.2001
https://doi.org/10.1038/nm.2001

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. http://dx.doi.org/10.1371/journal.pone.0016376
https://doi.org/10.1371/journal.pone.0016376

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. http://dx.doi.org/10.4049/jimmunol.1002615
https://doi.org/10.4049/jimmunol.1002615