Relationship Between Hba1c Levels and Inflammatory Biomarkers (C - Reactive Protein, Il6 and TNF-Alpha) Among Type 2 Diabetes Mellitus-Khartoum- Sudan

Abstract

Introduction: World most prevalence disease, is diabetes mellitus, with countless causes, it on increasing, genetic, lifestyle, infections could all be contributors as causative agents especially type 2 diabetes mellitus, increase inflammatory biomarkers plays extremely critical and vital role in progression of type 2 diabetes mellitus. So this study aimed to assess glycated hemoglobin levels and inflammatory biomarkers among T2DM and find such correlation and compare data with healthy control.
 Method: Cross-sectional case control study among 100 case group T2DM and 100 healthy subjects as control group, HbA1c and inflammatory biomarkers, C-reactive protein, IL6 and TNF-alpha were measured for study groups. Enzyme linked immunoassay (ELISA) used for measurement of inflammatory biomarkers TNF-α, CRP, IL6 and Cystatin C. while HbA1c assessed by ichroma device.
 Result: HbA1c, C-reactive protein, IL6 and TNF-alpha were increased among T2DM patients than healthy subjects, giving increased significant difference for each, as p value <0.05. Pearson’s correlation of HbA1c with each of measured parameters showed that HbA1c has positive correlation with inflammatory biomarkers TNF-α. (R= 0.812** P=0.00), CRP(R= 0.527** P=0.00), IL6, (R= 0.778** P=0.00) and Cystatin C (R= 0.884** P=0.00) respectively.
 Conclusion: higher levels of inflammatory biomarkers associate with increase with glycated hemoglobin, Improvement of glycemic control reduce risk markers for development of diabetic complications.
 Key words: HbA1c Levels and inflammatory biomarkers, tumor necrosis factor, interleukin 6.

Association of inflammatory markers, serum ferritin and high sensitive C reactive protein, with HbA1c and dyslipidemia in male patients of type 2 diabetes mellitus

“…It has been seen that inflammatory markers such as CRP, IL-6, and TNF alpha are positively correlated with HbA1c in type 2 diabetic patients showing a pathogenetic link between inflammation and development of insulin resistance. 4 Serum ferritin level has been found to be associated with rise in TCHOL, TGL, and LDL CHOL but decrease in HDL CHOL level independent of liver and renal function status showing some link between free radical injury mediated by ferritin and lipid peroxidation eventually resulting into dyslipidemia thus initiating a cascade for development of insulin resistance. 5 HbA1c has been found to be positively correlated with inflammatory markers in the aqueous humor of patients with diabetic cataract.…”

“…High levels of the acute phase reactants C-reactive protein (CRP) have been reported to correlate with insulin resistance. 4 Serum ferritin has also been reported to have a significant role in the development of insulin resistance in metabolic syndrome as well as DM. 5 However, now, there is increasing evidence that elevated body iron stores, evaluated by serum ferritin, may be associated with hypertension, dyslipidemia, elevated fasting insulin and blood glucose, and central obesity.…”

HUBUNGAN HbA1c DENGAN CRP PADA PENDERITA DIABETES MELITUS TIPE-2 DENGAN OBESITAS DAN TANPA OBESITAS

“…13 Hasil penelitian yang dilakukan oleh Omer dan Ali pada tahun 2019 juga menyatakan bahwa terdapat hubungan positif antara kadar HbA1c dan kadar CRP (p=0,000, r=0,527). 18 Perbedaan dari penelitian yang dilakukan oleh Sasidharan et al dan penelitian ini terletak pada kriteria inklusi subjek dan rata-rata kadar HbA1c. Pada penelitian yang dilakukan oleh Sasidharan et al, kriteria inklusi adalah pasien dengan kadar glukosa darah puasa >126 mg/dL dan glukosa postpandrial >200 mg/dL.…”

The association between leptin and inflammatory markers with obesity indices in Zanzibari children, adolescents, and adults

“…CRP has been used as a marker for obesity‐related low‐grade inflammation, which contributes to insulin resistance 1 . Furthermore, higher levels of inflammatory biomarkers CRP, IL‐6, and TNF‐α were reported to be associated with increased glycated hemoglobin (HbA1c) as a marker for type 2 diabetes mellitus 6 . In turn, obesity measured using different indices, such as waist circumference (WC) and body mass index (BMI), was associated with higher serum CRP levels and TNF‐α 3,7 …”