Higher oxidative stress and inflammation in obese compared to lean patients with type 2 diabetes mellitus

Abstract

Aim

To compare mRNA [messenger RNA] expression of RELA, NFκB1, TNF-α, IL-6 and MCP-1 in whole blood & serum Total Antioxidant status [TAS] in newly diagnosed lean and obese patients with T2DM.

Methods

Newly diagnosed treatment naïve patients of T2DM were enrolled in this study. The patients were divided into two groups of 30 patients each, lean (BMI< 18.5 kg/m²) and obese (BMI >25 kg/m²) groups. mRNA expression of RELA, NFκB1, TNF-α, IL-6 and MCP-1 was measured by real time PCR. Serum TAS was measured using a commercially available kit.

Results

There was a 2.7-fold increase in mRNA expression of RELA in obese group compared to the lean group. There was a 1.3-fold increase in mRNA expression of NFκB1, a 3.24-fold increase in mRNA expression of TNF-α, a 4.7-fold increase in mRNA expression of IL 6 and a 3.8-fold increase in mRNA expression of MCP-1 in obese group compared to the lean group. Mean fasting serum insulin levels were 16.07 ± 8.39 μIU/mL in the lean group and 27.11 ± 4.91μIU/mL in the obese group (p = 0.001). Mean TAS level was 5.39 ± 2.28 μM Trolox Equivalents in the obese group and 3.85 ± 3.33 μM Trolox Equivalents in the lean group (p = 0.001).

Conclusion

Inflammation and OS is higher in obese patients of T2DM compared to lean patients of T2DM. This could be the result of excess adipokines production or resistance to the anti-inflammatory effects of insulin with multiple explanations. Our study suggests a difference in the pathogenic mechanism in lean patients when compared with obese T2DM patients.