Hypertension in Obese Type 2 Diabetes Patients is Associated with Increases in Insulin Resistance and IL-6 Cytokine Levels: Potential Targets for an Efficient Preventive Intervention

Abstract

Increased body weight as well as type 2 diabetes (T2D) are found to be associated with increased incidence of hypertension, although the mechanisms facilitating hypertension in T2D or nondiabetic individuals are not clear. Therefore, in this study we compared the levels of insulin resistance (IR:OGIS), plasma insulin (PI:RIA) levels, and pro-inflammatory cytokines (IL-6 and TNF-α: ELISA), being risk factors previously found to be associated with hypertension, in T2D patients showing increased body weight (obese and overweight, BMI ≥ 25 kg/m2) with hypertension (group A, N = 30), or without hypertension (group B, N = 30), and in nonobese (BMI < 25 kg/m2), normotensive controls (group C, N = 15). We found that OGIS index was the lowest (A: 267 ± 35.42 vs. B: 342.89 ± 32.0, p < 0.01) and PI levels were the highest (A: 31.05 ± 8.24 vs. B: 17.23 ± 3.23, p < 0.01) in group A. In addition, IL-6 levels were higher in group A (A: 15.46 ± 5.15 vs. B: 11.77 ± 6.09; p < 0.05) while there was no difference in TNF-α levels. Our results have shown that appearance of hypertension in T2D patients with increased body weight was dependent on further increase in IR which was associated with the rise in pro-inflammatory IL-6 cytokine. The results imply that lifestyle intervention aimed to decrease IR might be beneficial in reducing the risk for hypertension in those T2D individuals.

IL-6, TNF-α, and IL-10 levels/polymorphisms and their association with type 2 diabetes mellitus and obesity in Brazilian individuals

“…or only in obese individuals (38,45,46). We performed an analysis in order to investigate the influence of BMI in cytokine levels.…”

Body mass index and insulin resistance as independent predictors of hypertension in postmenopausal women

“…Furthermore, some studies suggest that the presence of a low-grade inflammation could predict the future onset of hypertension [9]. Lukic et al [9] showed that increases in inflammation might be an important factor influencing the occurrence of hypertension in obese patients with diabetes, but which was associated with the rise in interleukin-6 (IL-6).…”

“…Lukic et al [9] showed that increases in inflammation might be an important factor influencing the occurrence of hypertension in obese patients with diabetes, but which was associated with the rise in interleukin-6 (IL-6). Another pathogenic mechanism of hypertension onset may be attributed to the role of arterial stiffening which precedes the hypertension occurrence [20].…”

“…Blood pressure was measured and Glomerular filtration rate was estimated (eGFR) as described previously [2,3]. Hypertension was defined as (systolic/diastolic blood pressure (BP) (≥140/≥90 mmHg) [9]. Statistical analysis Statistical data of the study populations are presented as mean ± standard deviation for www.tmg.org.rs normally distributed data, as geometric means (95% confidence interval -CI) for log-normally distributed data [12] and as median (interquartile range) for skewed distributed data.…”

“…It is speculated that redistribution of adipose tissue towards visceral region, due to hormonal changes may be the main pathogenic entity, consequently leading to increased cardiometabolic risk [4] in postmenopause. Increased visceral fat mass is a source of proinflammatory adipocytokines [5][6][7][8], exerting a low-grade inflammation environment which could predispose to the future hypertension occurrence [9]. In addition, increased abdominal fat mass is accompanied with increased insulin resistance [4,8].…”