Inter-relationship of pro- and anti- inflammatory biomarkers with the development of type 2 diabetes mellitus

Purpose: There has been growing evidence that inflammatory markers play a role in the development as well as severity of Type 2 diabetes mellitus (T2DM). This study has been designed to decipher the involvement of C -Reactive Protein (CRP), Tumor Necrosis Factor (TNF alpha), Interleukin-6 (IL-6) and Interleukin-10 (IL-10) in the etiopathogenesis of T2DM.Basic procedures: A total of 480 T2DM cases and 540 healthy controls were recruited for the study. Blood samples were collected from each study subject to measure the serum levels of CRP, TNF alpha, IL-6 and IL-10.Main findings: We found that serum levels of CRP in mg/dl (4.2 +/- 0.9), TNF alpha in pg/ml (34.5 +/- 8.8), IL-6 in pg/ml (19.2 +/- 7.2) in T2DM patients were significantly high as compared to control participants (CRP; 1.4 +/- 0.6, TNF alpha; 12.7 +/- 3.4, IL-6; 3.1 +/- 1.4; P < 0.0001). The serum levels of IL-10 in pg/ml were lower in T2DM cases compared to controls (4.35 +/- 1.2 vs. 9.6 +/- 1.2). In addition, we observed a significant association of CRP levels with insulin resistance, obesity and dyslipidemia. Increased TNF alpha levels were strongly associated with female gender, Poor glycemic control and strong family history of diabetes. Poor glycemic control was significantly associated with elevated IL-6 levels. Moreover, significantly reduced IL-10 levels were found in T2DM patients with sedentary lifestyle; low educational and rural background.Conclusions: This study showed a strong relationship between TNF alpha, IL-6, CRP, IL-10 and T2DM patients of Kashmiri ethnicity, treated at SMHS Hospital. Thus, supporting other studies and showing that cytokines may be good markers for T2DM development.