Proinflammatory cytokines, ultrasensitive C-reactive protein and atherogenic risk in patients with type 2 diabetes: impact of the degree of glycemic control
DOI:
https://doi.org/10.47196/diab.v59i3.1289Keywords:
type 2 diabetes, IL-6, TNF-α, cardiovascular risk, glycated hemoglobinAbstract
Introduction: type 2 diabetes is characterized by a chronic proinflammatory state associated with metabolic and cardiovascular complications.
Objectives: to determine the concentrations of interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), ultrasensitive C-reactive protein (hs-CRP) and plasma atherogenic index (PAI), and to analyze their association with glycosylated hemoglobin (HbA1c) levels in patients with type 2 diabetes mellitus (DM2).
Material and methods: an observational, cross-sectional, correlational study was conducted in 300 participants (240 diagnosed with T2DM and 60 healthy controls). Patients with T2DM were classified into three groups according to their HbA1c levels: group 1 (<7%), group 2 (7-9%), and group 3 (>9%). Biochemical, inflammatory, and anthropometric parameters were assessed. Statistical analysis included ANOVA, Pearson classification, and multivariate logistic regression.
Results: Patients with worse glycemic control (HbA1c >9%) showed significantly higher levels of glucose, body mass index, triglycerides, PAI, IL-6, TNF-α and hs-CRP (p<0.05). A positive correlation was identified between HbA1c levels and inflammatory and atherogenic biomarkers: IL-6 (r=0.5539; p<0.0001), TNF-α (r=0.1769; p<0.0001), hs-CRP (r=0.3535; p<0.0001) and PAI (r=0.2416; p<0.0001). In the multivariate analysis, hs-CRP and PAI behaved as independent predictors of poor glycemic control.
Conclusions: Poor glycemic control in DM2 is associated with an adverse immunometabolic profile. Elevated proinflammatory cytokines, hs-CRP and plasma atherogenic index suggest increased cardiovascular risk. Incorporating these markers into clinical practice may strengthen the comprehensive assessment of the patient and guide more effective therapeutic decisions.
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