Influence of Age, Gender, Frailty, and Body Mass Index on Serum IL-17A Levels in Mature Type 2 Diabetic Patients

Abstract

Background The cytokine IL-17A is emerging as a marker of chronic inflammation in cardio-metabolic conditions. This study aimed to identify relevant factors that in older primary care patients with type 2 diabetes (T2D) could influence serum IL-17A concentrations. The results have a potential to improve risk stratification and therapy options for these patients. Material/Methods The study was conducted during a period of 4 months, in 2020, in the south-eastern region of Croatia. Patients from primary health care, diagnosed with T2D (N=170, M: F 75: 95, ≥50 years old), were recruited at their visits. Those with malignant diseases, on chemotherapy or biological therapy, with amputated legs, or at hemodialysis, were excluded. The multinomial regression models were used to determine independent associations of the groups of variables, indicating sociodemographic and clinical characteristics of these patients, with increasing values (quartiles) of serum IL-17A. Results The regression models indicated the frailty index and sex bias are the key modifying factors in associations of other variables with IL-17A serum values. Conclusions Sex bias and the existence of different frailty phenotypes could be the essential determining factors of the serum IL-17A levels in community-dwelling patients with T2D age 50 years and older. The results support the concept of T2D as a complex disorder.

Cluster analysis of patient characteristics, treatment modalities, renal impairments, and inflammatory markers in diabetes mellitus

“…One of the possible reasons for such discrepancies includes the wide range of age of studied diabetic patients that could have influenced the characteristics of clusters, in addition to differences in medications use. Furthermore, there are complex relationships between age, gender, postmenopausal status, T2DM duration, body shape, BMI categories, HbA1c, and inflammatory marker values as observed in previous studies 29 , 30 .…”

The Reasons for the Low Uptake of New Antidiabetic Drugs with Cardiovascular Effects—A Family Doctor Perspective

“…This is especially true for elderly patients with T2D, where many factors interact in predicting the measurable outcomes, of which some may have alleviating effects and some may have worsening effects. In our recently published article, we demonstrated that the level of inflammation may vary among T2D patients, which is determined at least by variables such as age, sex, BMI and the level of frailty [ 33 ]. Any level of frailty, including mild, moderate and severe, was shown to increase the risk for all-cause and CV-related mortality in patients with CKD, but with different magnitudes of influence [ 85 ].…”

“…Studies that assess the feasibility of using clustering techniques from data science application areas are underway, wanting to identify subcategories of patients with T2D that can be discriminated against in terms of CV and other poor outcomes and responses to treatment. Our research group has contributed to these efforts [ 32 , 33 , 89 ]. Regarding treatment, precision medicine looks at variations in drug effectiveness in specific patient subgroups and seeks markers (especially genetic markers) that can predict adverse drug events [ 87 ].…”

“…The unpublished results from our research that is cited in refs. [ 32 , 33 ] (N = 170, F:M = 95:75, age 50–89 years, median 66). The simplified criteria for prescribing GLP-1ra or SGLT2inh: C1: Atherosclerotic CVD (Coronary artery disease, Periphery artery disease or Cerebrovascular disease); C2: Age ≥ 55 years + chronic heart disease; C3: estimated glomerular filtration rate ((eGFR) < 60 mL/min).…”

“…The growing evidence indicates that the clinical expression of frailty is sex-dependent, which means that women are more prone to frailty and frailty-related physical disability than The results from our research that is cited in ref. [33].…”