Increased Serum Cytokines Levels in Type 2 Diabetes Mellitus Associated with Arterial Hypertension: A Link to Cardio-Metabolic Risk Factors

ABSTRACT

Purpose: Serum levels of cytokines as well as the inflammatory markers are increased in type 2 diabetes (T2D) patients. Few studies mention the association of hypertension with proinflammatory and inflammatory biomarkers in T2D patients. This study aimed to test the hypothesis that there is alteration in serum levels of cytokines in T2D patients with hypertension compared with normotensive T2D patients taking into consideration the cardio-metabolic risk factors, such as obesity and dyslipidemia.
Material and Method: A cross-sectional study was carried out in the Center of Diabetes Mellitus in Erbil in cooperation with College of Pharmacy-Hawler Medical University and College of Medicine, Al-Mustansiriya University in Iraq. A total of 180 patients with T2D were classified as normotensive (group 1) and hypertensive (group 2). Cardio-metabolic risk factors were evaluated via measuring body weight, body mass index, waist circumference, blood pressure, fasting serum glucose and lipid profile, glycosylated hemoglobin A1c and high-sensitivity C-reactive protein. Serum interleukin- (IL)-1β, IL-17, and tumor necrosis factor-alpha (TNF-α) were measured using the enzyme-linked immunosorbent assay method.
Results: The measurements of cardio-metabolic risk factors in group 2 were significantly higher than in group 1. Significant high serum levels of IL-1β, IL-17, TNF-α and high-sensitivity C-reactive protein were observed among group 2 patients. Fasting serum triglyceride levels significantly correlated with IL-17 and TNF-α among groups 1 and 2 patients whereas significantly correlated with IL-1β among group 2 patients only.
Discussion: Proinflammatory and inflammatory markers are significantly high among patients with T2D with hypertension. There is an inverse relationship between the components of metabolic syndrome and the cytokines levels in group 2 patients.