scholarly journals Elevated Serum TNF-α Is Related to Obesity in Type 2 Diabetes Mellitus and Is Associated with Glycemic Control and Insulin Resistance

2020 ◽  
Vol 2020 ◽  
pp. 1-5 ◽  
Author(s):  
Hana Alzamil

Background. Diabetes and obesity are very common associated metabolic disorders that are linked to chronic inflammation. Leptin is one of the important adipokines released from adipocytes, and its level increases with increasing body mass index (BMI). Tumor necrosis factor alpha (TNF-α) is a cytokine that is released by adipocytes and inflammatory cells in response to chronic inflammation. Type 2 diabetes mellitus (T2DM) is believed to be associated with low-grade chronic inflammation. The current study aims to investigate the involvement of leptin and TNF-α in T2DM associated with obesity. Methodology. This is a cross-sectional study involving 63 healthy volunteers and 65 patients with T2DM. Body composition was measured, and fasting venous blood samples were analyzed for blood glucose, glycosylated hemoglobin (HbA1c), basal insulin, leptin, and TNF-α. HbA1c was measured by the affinity column method. Insulin, leptin, and TNF-α immunoassays were performed by the ELISA technique. Insulin resistance and beta-cell function were assessed using the homeostasis model assessment (HOMA-IR and HOMA-B). Results. Our study showed a significantly higher level of TNF-α in T2DM patients compared to controls (7.51 ± 2.48 and 6.19 ± 3.01, respectively; p=0.008). In obese diabetic patients, the serum level of TNF-α was significantly higher in comparison with nonobese diabetic patients (p<0.018) and obese nondiabetic group (p<0.001). TNF-α correlated positively with HbA1c (r = 0.361, p=0.003) and HOMA-IR (r = 0.296, p=0.017) in patients with T2DM. Conclusion. TNF-α is associated with concurrent obesity and T2DM and correlates with HbA1c. This suggests that TNF-α needs further investigation to explore if it has a role in monitoring the effectiveness of management in individuals with obesity and T2DM.


2017 ◽  
Vol 14 (2) ◽  
pp. 116-121 ◽  
Author(s):  
Wen-Jia Chen ◽  
Yue Liu ◽  
Yu-Bin Sui ◽  
Bo Zhang ◽  
Xiao-Hui Zhang ◽  
...  

Background: Musclin is a newly identified skeletal muscle–derived secretory factor, which has been recently characterized as a stimulator that induces insulin resistance in mice. However, the pathophysiological role of musclin in humans remains poorly understood. The aim of this study was to explore the potential correlations between musclin plasma levels and various metabolic parameters in patients with type 2 diabetes mellitus. Materials and methods: In this hospital-based study, plasma samples were collected from the enrolled individuals, including 38 newly diagnosed, treatment-naive type 2 diabetes mellitus patients and 41 age- and gender-matched control subjects. Plasma musclin levels were examined by radioimmunoassay. Results: Compared with the control group, musclin plasma levels were significantly higher in untreated type 2 diabetes mellitus patients. Musclin levels in the plasma of newly diagnosed type 2 diabetes mellitus patients were positively correlated with fasting plasma glucose, haemoglobin A1c, serum insulin, triglycerides and homeostasis model assessment of insulin resistance. Furthermore, multivariate logistic regression analysis showed that the level of musclin was associated with the presence of type 2 diabetes mellitus. Receiver operating characteristic curve analysis yielded an area under the curve for musclin of 0.718 in type 2 diabetes mellitus. Conclusion: The circulating concentration of musclin was significantly increased in type 2 diabetes mellitus patients. Our results suggest that musclin has a strong relationship with insulin resistance in type 2 diabetes mellitus.



2020 ◽  
Author(s):  
Atieh Ghafouri ◽  
Sahar Jafari Karegar ◽  
Ghazaleh Hajiluian ◽  
Sharieh Hosseini ◽  
Shahrzad Shidfar ◽  
...  

Abstract Background: This study was conducted to determine the effect of Rheum ribes supplementation on glycemic indices and apolipoproteins in patients with type 2 diabetes mellitus (DMT2).Methods: In this randomized controlled trial, sixty type 2 diabetic patients, aged 30-60 years with body mass index (BMI) of 20-30 kg/m 2 , and hemoglobin A1c (HbA1c) of 6-8% were included. The patients were randomly assigned to receive 450 mg of Rheum ribes aqueous extract (AG), 450 mg of Rheum ribes ethanolic extract (EG) or placebo (PG), three times daily for 6 weeks. Then glucose, the homeostatic model assessment (HOMA-IR and HOMA-B) and apolipoprotein A-I (ApoA1) and apolipoprotein B (ApoB) were measured.Results: According to these findings, in the AG and EG intervention groups, we observed a significant reduction in serum levels of insulin (P=0.003 and P=0.001, respectively), HOMA-IR (P=0.01 and P=0.001, respectively) and HOMA-B (P=0.002 and P=0.001, respectively) indices, without no significant changes in glucose. There was also a significant reduction in serum levels of ApoB (P=0.006 and P=0.03, respectively) and ApoB/ApoA1 ratio (P=0.016 and P=0.04, respectively) in both AG and EG. Intervention in both AG and EG had increasing effects on ApoA1 (P=0.08 and P=0.05, respectively). None of these variables had a significant change in PG. At the end of study, there were significant differences in insulin (P=0.04), HOMA-IR (P=0.03), HOMA-B (P=0.01), ApoB (P=0.02), and ApoB/ApoA1 (P=0.03) ratio among groups.Conclusions: Rheum ribes intake may have favorable effects on insulin resistance and apolipoproteins in diabetic patients.Trial registration: The study was recorded in Iranian Registry of Clinical Trials under the registration number of IRCT201410142709N31 (Registration date: 2014-12-11, https://en.irct.ir/trial/2543 ).



2019 ◽  
Vol 70 (5) ◽  
pp. 1791-1794
Author(s):  
Elena-Daniela Grigorescu ◽  
Victorita Sorodoc ◽  
Mariana Floria ◽  
Ecaterina Anisie ◽  
Alina Delia Popa ◽  
...  

Low-grade inflammation is not only a specific feature in type 2 diabetes mellitus, but also a contributor to cardiovascular risk. Together with insulin resistance as the main characteristic of type 2 diabetes mellitus, subclinical imflammation maintains a vicious cycle of health-damaging processes. Our study assessed the inflammatory marker hsCRP in relation to the metabolic profiles of type 2 diabetic patients without clinical atherosclerotic manifestations. The results confirmed the hypothesized connection, which should be taken into consideration when designing and recommending diabetes care plans.



2021 ◽  
Vol 49 (11) ◽  
pp. 030006052110482
Author(s):  
Xiaoqin Ha ◽  
Xiaoling Cai ◽  
Huizhe Cao ◽  
Jie Li ◽  
Bo Yang ◽  
...  

Objective Insulin resistance (IR) is a key defect in type 2 diabetes mellitus (T2DM); therefore, effective means of ameliorating IR are sought. Methods We performed a retrospective cohort study of 154 patients with T2DM and 39 with pre-diabetes (pre-DM). The effects of IR and a high concentration of FFA on gene expression were determined using microarray analysis and quantitative reverse transcription polymerase chain reaction (RT-qPCR) in patients with T2DM or pre-DM. Results Serum FFA concentration and homeostasis model assessment of IR (HOMA-IR) were significantly higher in patients with T2DM but no obesity and in those with pre-DM than in controls. HOMA-IR was significantly associated with T2DM. RT-qPCR showed that the expression of FBJ murine osteosarcoma viral oncogene homolog ( FOS) and AE binding protein 1 ( AEBP1) was much lower in the circulation of participants with obesity and diabetes. RT-qPCR showed that the expression of docking protein 1 ( DOK1) was significantly lower in the blood of participants with diabetes but no obesity and in those with pre-DM than in controls. Conclusions FFA and DOK1 are associated with IR in patients with T2DM but no obesity or pre-DM. The downregulation of DOK1 might inhibit lipid synthesis and induce lipolysis, inducing or worsening IR.



Author(s):  
Zhu Li ◽  
Yan-Ling Yang ◽  
Yan-Juan Zhu ◽  
Chen-Guang Li ◽  
Yun-Zhao Tang ◽  
...  

Abstract Objective Myonectin is one of the myokines and has gained interest as a potential new strategy to combat obesity and its associated disorders, such as type 2 diabetes mellitus (T2DM).The objective of this study was to investigate circulating serum myonectin levels in nondiabetes and T2DM and elucidate possible relationships between serum myonectin levels and metabolic parameters in patients with T2DM. Design A total of 362 Chinese patients with T2DM and 100 age- and sex-matched healthy controls were recruited in this study. Clinical characteristics, blood biochemistry, and circulating myonectin levels were measured by enzyme-linked immunosorbent assay. Results Circulating myonectin levels were significantly decreased in T2DM compared with controls. Obese nondiabetic controls had significantly lower serum myonectin levels compared with lean nondiabetic controls. In diabetic patients, serum myonectin concentrations were significantly negatively correlated with body mass index (BMI), total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), C-reactive protein (CRP), hemoglobin A1c (HbA1c), fasting insulin (Fins), the homeostatic model assessment of insulin resistance (HOMA-IR), visceral fat area, and subcutaneous fat area. After adjusting for covariates, multivariate stepwise regression analysis demonstrated that BMI, LDL-C, TG, HOMA-IR, and visceral fat were the main independent predictors of low serum myonectin concentrations. Conclusions Circulating myonectin levels were decreased in T2DM patients and in obese subjects. Moreover, serum myonectin levels were correlated with metabolic markers of T2DM. These data suggest that myonectin may be a useful marker in predicting the development of obesity and T2DM.



2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Rong-Tsung Lin ◽  
Huei-Chin Pai ◽  
Yu-Chen Lee ◽  
Chung-Yuh Tzeng ◽  
Chin-Hsien Chang ◽  
...  

Aims.To evaluate the efficacy of rosiglitazone (TZD) and electroacupuncture (EA) combined therapy as a treatment for type 2 diabetes mellitus (T2DM) patients by randomized single-blind placebo controlled clinical trial.Methods.A total of 31 newly diagnostic T2DM patients, who fulfilled the study's eligibility criteria, were recruited. The individuals were randomly assigned into two groups, the control group (TZD,N=15) and the experimental group (TZD + EA,N=16). Changes in their plasma free fatty acid (FFA), glucose, and insulin levels, together with their homeostasis model assessment (HOMA) indices, were statistically compared before and after treatment. Hypoglycemic activity (%) was also compared between these two groups.Results.There was no significant difference in hypoglycemic activity between the TZD and TZD + EA group. The effectiveness of the combined therapy seems to derive from an improvement in insulin resistance and a significant lowering of the secreted insulin rather than the effect of TZD alone on T2DM. The combined treatment had no significant adverse effects. A lower plasma FFA concentration is likely to be the mechanism that causes this effect.Conclusion.This combined therapy seems to suppress endogenous insulin secretion by improving insulin resistance via a mechanism involving a reduction in plasma FFA. This trial is registered with ClinicalTrials.govNCT01577095.



Medicina ◽  
2021 ◽  
Vol 57 (11) ◽  
pp. 1249
Author(s):  
Oana Irina Gavril ◽  
Lidia Iuliana Arhire ◽  
Radu Sebastian Gavril ◽  
Madalina Ioana Zota ◽  
Andreea Gherasim ◽  
...  

Background and Objectives: Non-alcoholic fatty liver disease is a worldwide significant public health problem, particularly in patients with type 2 diabetes mellitus. Identifying possible risk factors for the disease is mandatory for a better understandingand management of this condition. Patatin-like phospholipase domain-containing protein 3 (PNPLA3) has been linked to the development and evolution of fatty liver but not to insulin resistance. The aim of this study isto evaluate the relationships between PNPLA3 and fatty liver, metabolic syndrome and subclinical atherosclerosis. Materials and Methods: The study group consisted of patients with type 2 diabetes mellitus without insulin treatment. The degree of liver fat loading was assessed by ultrasonography, and subclinical atherosclerosis was assessed using carotid intima-media thickness (CIMT). PNPLA3 rs738409 genotype determination was performed by high-resolution melting analysis that allowed three standard genotypes: CC, CG, and GG. Results: Among the 92 patients, more than 90% showed various degrees of hepatic steatosis, almost 62% presented values over the normal limit for the CIMT. The majority of the included subjects met the criteria for metabolic syndrome. Genotyping of PNPLA3 in 68 patients showed that the difference between subjects without steatosis and subjects with hepatic steatosis was due to the higher frequency of genotype GG. The CC genotype was the most common in the group we studied and was significantly more frequent in the group of subjects with severe steatosis; the GG genotype was significantly more frequent in subjects with moderate steatosis; the frequency of the CG genotype was not significantly different among the groups.When we divided the group of subjects into two groups: those with no or mild steatosis and those with moderate or severe steatosis it was shown that the frequency of the GG genotype was significantly higher in the group of subjects with moderate or severe steatosis. PNPLA3 genotypes were not associated with metabolic syndrome, subclinical atherosclerosis, or insulin resistance. Conclusions: Our results suggest that PNPLA3 does not independently influence cardiovascular risk in patients with type 2 diabetes mellitus. The hypothesis that PNPLA3 may have a cardioprotective effect requires future confirmation.



2017 ◽  
Vol 70 (11-12) ◽  
pp. 437-443
Author(s):  
Romana Mijovic ◽  
Branislava Ilincic ◽  
Suncica Kojic-Damjanov ◽  
Biljana Vuckovic ◽  
Radmila Zeravica ◽  
...  

Introduction. Endothelium is a dynamic, strategically positioned defensive regulator of vascular homeostasis. Physiology and Pathophysiology of Vascular Endothelium. Endothelial phenotypic modulation involves five basic characteristics: the expression of leukocyte adhesion molecules, the production of cytokines, change in the shape and the permeability of the endothelium, prothrombotic changes and upregulation of autoantigens. Obesity, Metabolic Inflammation and Vascular Endothelium One of the most important pathophysiological manifestations of adiposopathy may be the phenotypic conversion of vascular endothelium. Insulin Resistance and Vascular Endothelium. Under the conditions of insulin resistance and consequent hyperinsulinemia, there is imbalance between the production of endothelial vasoconstrictors and vasodilators, increased expression of adhesion molecules, and platelet hyperreactivity. Hyperglycemia and Vascular Endothelium. Hyperglycemia causes endothelial dysfunction by various mechanisms that involve activation of polyol pathway and production of sorbitol, increased formation of advanced glycation end products, activation of various isoforms of protein kinase C and activation of hexosamine pathway. Dyslipidemia and vascular endothelium. Dyslipidemia takes an important role in a cascade of pathophysiological processes that result in endothelial activation and chronic dysfunction. Conclusion. Hyperglycemia, hyperinsulinemia, insulin resistance, dyslipidemia, visceral obesity and low-grade inflammation are the main factors responsible for development of endothelial dysfunction in type 2 diabetes mellitus.



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