Abstrakt

Background: Inflammation is involved in initiation and progression of diabetic complications relatedto cell damage of tissues, especially endothelial cells, and deepening of metabolic disturbances. Thisstudy was conducted in order to assess potential associations between basic laboratory parametersof inflammation and common metabolic factors such as glycated hemoglobin and C-reactive protein.Materials and methods: The studied group consisted of 95 patients with diabetes mellitus type 2and 77 subjects without signs of disturbances in glucose metabolism, aged between 40 and 74 years.Fasting plasma glucose, glycated hemoglobin, complete blood count and high-sensitivity C-reactiveprotein concentration in blood were determined. Also blood pressure as well as weight and heightmeasurements were taken to calculate BMI.Results: Fasting plasma glucose and glycated hemoglobin concentrations, total leukocyte count andgranulocytes were significantly higher in diabetics. Significant correlations between both glycatedhemoglobin and BMI and C-reactive protein concentration were noted. However, after adjustingfor age and gender, leucocyte count was independently related to BMI and glycated hemoglobin,while C-reactive protein concentration was dependent on gender and BMI.Conclusion: Glycated hemoglobin as a marker of long-term glycemic control and BMI as an indicatorof adipose tissue accumulation are significantly related to white blood cell count and C-reactiveprotein concentration, even when values of these parameters are in the normal range. Thisis consistent with the hypothesis that chronic activation of the immune system plays a role in thepathogenesis and progression of type 2 diabetes.

Przypisy

• 1. American Diabetes A. Standards of Medical Care in Diabetes – 2013 Diabetes Care, 2013; 36 (Suppl. 1): S11-S66 2 Bergmann K., Olender K., Odrowąż-Sypniewska G.: Rola otyłości istanu zapalnego w cukrzycy typu 2 – znane fakty, nowe kontrowersje.Diagn. Lab., 2012; 48: 313-322
  Google Scholar
• 2. diabetic patiens. J. Pre-Clin. Clin. Res., 2011; 5: 22-27
  Google Scholar
• 3. Bergmann K., Sypniewska G.: Diabetes as a complication of adiposetissue dysfunction. Is there a role for potential new biomarkers?Clin. Chem. Lab. Med., 2013; 51: 177-185
  Google Scholar
• 4. Calder P.C., Ahluwalia N., Brouns F., Buetler T., Clement K., CunninghamK., Esposito K., Jonsson L.S., Kolb H., Lansink M., Marcos A.,Margioris A., Matusheski N., Nordmann H., O’Brien J., et al.: Dietaryfactors and low-grade inflammation in relation to overweight andobesity. Br. J. Nutr., 2011; 106, Suppl. 3: S5-S78
  Google Scholar
• 5. Colak A., Akinci B., Diniz G., Turkon H., Ergonen F., Yalcin H.,Coker I.: Postload hyperglycemia is associated with increased subclinicalinflammation in patients with prediabetes. Scand. J. Clin.Lab. Invest., 2013; 73: 422-427
  Google Scholar
• 6. Defronzo R.A.: Banting Lecture. From the triumvirate to the ominousoctet: a new paradigm for the treatment of type 2 diabetesmellitus. Diabetes, 2009; 58: 773-795
  Google Scholar
• 7. Duncan B.B., Schmidt M.I., Pankow J.S., Ballantyne C.M.,Couper D., Vigo A., Hoogeveen R., Folsom A.R., Heiss G.: Lowgradesystemic inflammation and the development of type 2diabetes: the atherosclerosis risk in communities study. Diabetes,2003; 52: 1799-1805
  Google Scholar
• 8. Farhangi M.A., Keshavarz S.A., Eshraghian M., Ostadrahimi A.,Saboor-Yaraghi A.A.: White blood cell count in women: relation toinflammatory biomarkers, haematological profiles, visceral adiposity,and other cardiovascular risk factors. J. Health Popul. Nutr.,2013; 31: 58-64
  Google Scholar
• 9. Festa A., D’Agostino R.Jr., Tracy R.P., Haffner S.M.: Elevated levelsof acute-phase proteins and plasminogen activator inhibitor-1predict the development of type 2 diabetes: the insulin resistanceatherosclerosis study. Diabetes, 2002; 51: 1131-1137
  Google Scholar
• 10. Ford E.S., Giles W.H., Mokdad A.H., Myers G.L.: Distribution andcorrelates of C-reactive protein concentrations among adult USwomen. Clin. Chem., 2004; 50: 574-581
  Google Scholar
• 11. Gao D., Bailey C.J., Griffiths H.R.: Metabolic memory effect ofthe saturated fatty acid, palmitate, in monocytes. Biochem. Biophys.Res. Commun., 2009; 388: 278-282
  Google Scholar
• 12. Gerner R.R., Wieser V., Moschen A.R., Tilg H.: Metabolic inflammation:role of cytokines in the crosstalk between adipose tissue andliver. Can. J. Physiol. Pharmacol., 2013; 91: 867-872
  Google Scholar
• 13. Gkrania-Klotsas E., Ye Z., Cooper A.J., Sharp S.J., Luben R., Biggs M.L.,Chen L.K., Gokulakrishnan K., Hanefeld M., Ingelsson E., Lai W.A., LinS.Y., Lind L., Lohsoonthorn V., Mohan V., et al.: Differential white bloodcell count and type 2 diabetes: systematic review and meta-analysisof cross-sectional and prospective studies. PLoS One, 2010; 5: e13405
  Google Scholar
• 14. Greenfield J.R., Campbell L.V.: Relationship between inflammation,insulin resistance and type 2 diabetes: ‚cause or effect’? Curr.Diabetes Rev., 2006; 2: 195-211
  Google Scholar
• 15. Grzebyk E., Piwowar A.: Glycoxidative modification of albuminin medical research. Pol. Merkur. Lekarski, 2013; 34: 239-242
  Google Scholar
• 16. Gustavsson C.G., Agardh C.D.: Markers of inflammation in patientswith coronary artery disease are also associated with glycosylatedhaemoglobin A1c within the normal range. Eur. Heart J.,2004; 25: 2120-2124
  Google Scholar
• 17. International Diabetes Federation. IDF Diabetes Atlas, 6th edn.Brussels, Belgium: International Diabetes Federation, 2013. http://www.idf.org/diabetesatlas (03.03.2014)
  Google Scholar
• 18. Jabeen F., Rizvi H.A., Aziz F., Watasi A.Z.: Hyperglycemia inducedvariations in hematological indices in type 2 diabetes. Int. J. Adv.Res., 2013; 1: 322-334
  Google Scholar
• 19. Kelsey M.M., Forster J.E., Van Pelt R.E., Reusch J.E., Nadeau K.J.:Adipose tissue insulin resistance in adolescents with and withouttype 2 diabetes. Pediatr. Obes., 2014; 9: 373-380
  Google Scholar
• 20. Lauria M.W., Moreira L.M., Machado-Coelho G.L., Neto R.M.,Soares M.M., Ramos A.V.: Ability of body mass index to predict abnormalwaist circumference: receiving operating characteristicsanalysis. Diabetol. Metab. Syndr., 2013; 5: 74
  Google Scholar
• 21. Martins A.R., Nachbar R.T., Gorjao R., Vinolo M.A., FestucciaW.T., Lambertucci R.H., Cury-Boaventura M.F., Silveira L.R., CuriR., Hirabara S.M.: Mechanisms underlying skeletal muscle insulinresistance induced by fatty acids: importance of the mitochondrialfunction. Lipids Health Dis., 2012; 11: 30
  Google Scholar
• 22. Narayan K.M., Gregg E.W., Fagot-Campagna A., Engelgau M.M.,Vinicor F.: Diabetes: a common, growing,serious,costly,and potentialypreventable public health problem. Diabetes Res. Clin. Pract.,2000; 50 (Suppl. 2): S77-S84
  Google Scholar
• 23. Pisarczyk-Wiza D., Zozulińska-Ziółkiewicz D., Wysocki H., Wierusz-WysockaB.: Increase in glycemia stimulates reactie oxygenspecies (ROS) production by polymorphonclear neutrophils in type
  Google Scholar
• 24. Reichkendler M.H., Auerbach P., Rosenkilde M., ChristensenA.N., Holm S., Petersen M.B., Lagerberg A., Larsson H.B., Rostrup E.,Mosbech T.H., Sjodin A., Kjaer A., Ploug T., Hoejgaard L., StallknechtB.: Exercise training favors increased insulin-stimulated glucoseuptake in skeletal muscle in contrast to adipose tissue: a randomizedstudy using FDG PET imaging. Am. J. Physiol. Endocrinol. Metab.2013; 305: E496-E506
  Google Scholar
• 25. Sekitani Y., Hayashida N., Kadota K., Yamasaki H., Abiru N., NakazatoM., Maeda T., Ozono Y., Takamura N.: White blood cell count and cardiovascularbiomarkers of atherosclerosis. Biomarkers, 2010; 15: 454-460
  Google Scholar
• 26. Strojek K., Majkowska L., Zozulińska D., Gumprecht J., KrzymieńJ., Małecki M.: Postprandial glycemia – review of current pathophysiological,epidemiological and clinical aspects. Pol. Arch. Med.Wewn., 2007; 117: 252-259
  Google Scholar
• 27. Tanni S.E., Pelegrino N.R., Angeleli A.Y., Correa C., Godoy I:.Smoking status and tumor necrosis factor-alpha mediated systemicinflammation in COPD patients. J. Inflamm., 2010; 7: 29
  Google Scholar
• 28. Tian J.Y., Yang Y., Cheng Q., Huang H.E., Li R., Jiang G.X., Liu S.Y.,Li X.Y., Ning G.: Association of WBC count and glucose metabolismamong Chinese population aged 40 years and over. Diabetes Res.Clin. Pract., 2008; 82: 132-138
  Google Scholar
• 29. Turner R.C., Millns H., Neil H.A., Stratton I.M., Manley S.E., MatthewsD.R., Holman R.R.: Risk factors for coronary artery disease innon-insulin dependent diabetes mellitus: United Kingdom ProspectiveDiabetes Study (UKPDS: 23). BMJ, 1998; 316: 823-828
  Google Scholar
• 30. Uysal K.T., Wiesbrock S.M., Marino M.W., Hotamisligil G.S.: Protectionfrom obesity-induced insulin resistance in mice lacking TNF–alpha function. Nature, 1997; 389: 610-614
  Google Scholar
• 31. van Greevenbroek M.M., Schalkwijk C.G., Stehouwer C.D.: Obesity-associatedlow-grade inflammation in type 2 diabetes mellitus:causes and consequences. Neth. J. Med., 2013; 71: 174-187
  Google Scholar
• 32. Vozarova B., Weyer C., Lindsay R.S., Pratley R.E., Bogardus C.,Tataranni P.A.: High white blood cell count is associated with a worseningof insulin sensitivity and predicts the development of type 2diabetes. Diabetes, 2002; 51: 455-461
  Google Scholar
• 33. Wellen K.E., Hotamisligil G.S.: Inflammation, stress, and diabetes.J. Clin. Invest., 2005; 115: 1111-1119
  Google Scholar
• 34. Wieser V., Moschen A.R., Tilg H.: Inflammation, cytokines andinsulin resistance: a clinical perspective. Arch. Immunol. Ther. Exp.,2013; 61: 119-125
  Google Scholar
• 35. Xu Y., Zhao Z., Li X., Bi Y., Xu M., Ning G.: Relationships betweenC-reactive protein, white blood cell count, and insulin resistance ina Chinese population. Endocrine, 2011; 39: 175-181
  Google Scholar
• 36. Yanbaeva D.G., Dentener M.A., Creutzberg E.C., Wesseling G.,Wouters E.F.: Systemic effects of smoking. Chest, 2007; 131: 1557-1566
  Google Scholar
• 37. Yudkin J.S., Juhan-Vague I., Hawe E., Humphries S.E., di MinnoG., Margaglione M., Tremoli E., Kooistra T., Morange P.E., LundmanP., Mohamed-Ali V., Hamsten A.: Low-grade inflammation may play arole in the etiology of the metabolic syndrome in patients with coronaryheart disease: the HIFMECH study. Metabolism, 2004; 53: 852-857
  Google Scholar
• 38. Zozulińska D., Wierusz-Wysocka B.: Hyperglycemia and inflammationare culprits of late diabetic complications. Arch. Med. Sci.,2005; 1: 115-118
  Google Scholar

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