Association of Inflammatory and Oxidative Stress Markers of Type 2 Diabetes Mellitus with Glycemic Control and Microvascular Complications

Abstract

Background: Type 2 diabetes mellitus (T2DM) is defined by persistent hyperglycemia which leads to oxidative stress and low-grade inflammation which causes microvascular complications. The interconnection between inflammatory signs, oxidative stress, and glycemic control is imperative to understanding of patients at risk. Purpose: The purpose of the study was to compare inflammatory (IL-6, TNF-a, hs-CRP) and oxidative stress (MDA, TAC, SOD) parameters between T2DM patients and healthy controls and determine the relationship between them and microvascular complications and glycemic control. Methods: 150 T2DM patients (75 with complications, 75 without complications) and 50 healthy controls were involved in this case-control study. Blood samples were fasted and compared in terms of HbA1c, fasting glucose, lipids profile, inflammatory (IL-6, TNF-a, hs-CRP), and oxidative stress (MDA, TAC, SOD) levels. The analysis of the predictive performance to complications was done using receiver operating characteristic (ROC) analysis. Findings: IL-6 (18.4+-4.2 vs 4.2+-1.1 pg/mL, P<0.001), TNF-a (28.6+-6.4 vs 8.4+-2.1 pg/mL, P<0.001), hs-CRP (6.8+-1.8 vs 1.2+-0.4 mg/L, P<0.001) were found to be significantly higher in T2DM patients than controls. The level of oxidative stress was high: the MDA level doubled, and the TAC fell by 48%. Further increases in IL-6 (24.6+-5.8 vs 12.4+-3.2 pg/mL, P<0.001) and MDA (8.4+-2.1 vs 4.8+-1.2 nmoI/mL, P<0.001) were found in patients with complications. The highest predictive accuracy of microvascular complications was IL-6/TAC ratio (AUC=0.92). Conclusion: There is a great increase of inflammatory and oxidative stress markers in T2DM patients, and additional increases in microvascular complication patients. The IL-6/TAC ratio can be used as an effective biomarker to detect patients with a risk of complications.