Influence of cytokine status on insulin resistance and circulating endothelial progenitor cells in type 2 diabetes mellitus.
BACKGROUND
Type 2 diabetes mellitus (T2DM), a chronic metabolic disorder caused by insulin resistance (IR) and elevated blood glucose level, may lead to endothelial dysfunction. This can result in the development of various vascular complications, even in clinically controlled glycemic state.


AIM
It has been experimentally proven that cytokine influences both IR and endothelial progenitor cell (EPC) dysfunction in T2DM patients. The present study evaluated the effect of clinical and metabolic risk factors and cytokine levels on IR and EPC, which are used as critical early biomarkers for estimating the risks associated with T2DM.


METHODS
The study involved 58 T2DM patients. They were further subdivided into three groups based on IR score: 32 (55.17%) with normal, 11 (18.97%) with mild-moderate and 15 (25.86%) with severe IR. The relationship of clinical, metabolic and immune mediators with IR and EPCs was verified.


RESULTS
HbA1c% was significantly elevated in severe (P=0.022) and mild-moderate IR groups (P= 0.012) than the normal group. The IR normal group had significantly elevated TNF levels compared to mild-moderate and severe groups. The regression analysis indicated that patients with increased body mass index (BMI) were 19.5% more likely to be significantly associated with severe IR. Association studies demonstrated that IL6 and IL10 values correlated with EPCs.


CONCLUSION
IL6 and IL10 were associated with circulating EPCs than IR and other clinical characteristics including glycemic control (glycated hemoglobin). TNF-α was associated with IR, but had no relationship with EPCs. The effect of cytokine status on IR and circulating EPCs in T2DM may indicate the risk of vascular complications.
['Sosale|Bhavana|B|', 'Chandrashekara|S|S|', 'Aravind|Sosale Ramachandra|SR|', 'Renuka|Panchagnula|P|', 'Anupama|K R|KR|']
D015415:Biomarkers D016207:Cytokines D003924:Diabetes Mellitus, Type 2 D066026:Endothelial Progenitor Cells D005260:Female D006801:Humans D007333:Insulin Resistance D008297:Male D008875:Middle Aged D015999:Multivariate Analysis D012044:Regression Analysis
Insulin resistance Endothelial progenitor cells Type 2 diabetes mellitus Anti-inflammatory cytokines Plasma biomarkers Pro-inflammatory cytokines