RESUMO
Background: Type II Diabetes mellitus (T2DM) is a multifactorial disease and a leading cause of premature deaths. Inflammatory cytokines are reported that they have potential to enhance insulin resistance and hence T2DM. Assessment of immunological profile in T2DM patients of Kashmir valley is unclear. So, detection of cytokines is relevant to determine the extent and direction of immune responses. The current research was taken to study the role of inflammatory mediators in T2DM along with insulin sensitivity, biochemical and hematological parameters in mountainous valley of Kashmiri population. Methods: A total of 340 subjects were selected in this study among them 160 were T2DM cases and 180 were healthy controls. Serum expression of inflammatory mediators (TNF-α and IL-6 ) were quantified by ELISA technique, WBC count was measured on Sysmax (Germany) hematology analyzer, biochemical and Immunoassay parameters were done on Abbott c4000 (USA) and Abbott C1000 (USA) fully automatic analyzer. Data was analyzed using statistical 'software SPSS 16.1' (Chicago, IL). For all assessments, p<0.05 were considered statistically significant. Results: The expressions of candidate cytokines (TNF-α, IL-6, CRP, and WBC) were highly significant (p<0.001) in T2DM. Among inflammatory mediators, TNF-α shows a positive correlation (p<0.001) with glycemic profile and insulin sensitivity in T2DM cases in comparison with healthy normal. Biochemical (fasting sugar, HbA1c, insulin resistance, lipid profile) and anthropometric (BMI) parameters were highly significant (p<0.001) in T2DM cases as compared to non-diabetic normal. Conclusion: Low grade inflammation and up regulation of inflammatory mediators has been purported to play a significant role in pathogenesis of T2DM. Our findings confirm that positive correlation of TNF-α and IL-6 with T2DM and insulin sensitivity. These can act as early prediction biomarkers of T2DM. Further studies on wider range of pro and anti- inflammatory cytokines i.e. mediators, in association with other biochemical, immunoassay and hematological parameters are needed to help clinicians manage and treat T2DM effectively.
RESUMO
OBJECTIVES: Approx 1 billion people across various ethnic and age groups have vitamin D deficiency. The high prevalence of such a deficiency is an imperative public health issue because hypovitaminosis D is an autonomous risk factor for mortality in the general population. Beyond bone integrity and calcium homeostasis, it is involved in numerous physiologic and pathologic processes. The role of vitamin D in the pathogenesis and prevention of type 2 diabetes mellitus has sparked universal interest. METHODS: This hospital-based case-control study was designed to study the association between 25-hydroxy vitamin D (25[OH]D) levels and the vitamin D receptor (VDR) gene polymorphism with diabetes and to evaluate their roles as risk factors for diabetes. 100 cases and controls were taken. 25(OH)D levels were analyzed by the chemilumenescence method using a Siemens ADVIA Centaur analyzer. Genomic DNA was extracted and Taq-1 and Bsm-1 genotyping in the VDR gene was done by using the polymerase chain reaction followed by restriction fragment length polymorphism (PCR-RFLP). RESULTS: 25(OH)D levels of patients with diabetes were significantly lower than those of controls (19.26±0.95 ng/mL vs. 25.49±1.02 ng/mL; p=0.001). 25(OH)D levels were found to be inversely associated with glycated hemoglobin percentages in cases (r2=0.74). The results suggested that the single nucleotide polymorphisms Taq-1 t(T) allele and b (G allele) in Bsm-1 might be a susceptibility allele for diabetes in the Kashmiri population. CONCLUSIONS: VDR gene polymorphisms appear to be an important genetic determinant in the progression of diabetes. Considering the important predisposition risk factor, we observed that Taq-1 and Bsm-1 were strongly associated with diabetes in northern Indians. But requires further study as a probable genetic risk marker for diabetes.