Inflammatory markers and their predictive role in pre-diabetes and diabetes

Background: Prevalence of diabetes has surged rapidly in the last decades. Insulin resistance is the chief contributor of this chronic disease. Inflammation (chronic low grade) is also mediates insulin resistance leading to hyperglycemia. Elevated concentrations of CRP, pro-inflammatory cytokines (IL-6), fibrinogen, Uric acid and decreased level of anti-inflammatory cytokines (adiponectin) are associated with increased risk of diabetes. Thus the purpose of this study was to evaluate the predictive role of these inflammatory mediators on the risk of diabetes development in future.
Method: With total 371 participants (100 controls, 271 patients: 145 pre-diabetic, 126 diabetic), this study was begun at Santosh Medical College and Hospital, Ghaziabad. Blood sample was collected for the estimation of adiponectin, fibrinogen, IL-6, CRP and uric acid. All the parameters were analysed using kit based methods.
Results: Significantly high values of inflammatory mediators (fibrinogen, IL-6, CRP, uric acid) and low values anti-inflammatory mediator (adiponectin) were obtained in pre-diabetic and diabetic patients compared to controls. In pre-diabetic subjects, except uric acid, all other mediators studied served as the potent risk factors as indicated by significant OR values i.e adiponectin (OR=1.97, p =0.0087), ), fibrinogen (OR=2.55, p=0.0004), IL-6 (OR=5.49, p <0.0001) and CRP (OR=3.93, p <0.0001. In case of diabetic subjects, all the inflammatory mediators posed significant threat to future diabetes i.e. adiponectin (OR=4.39, p<0.0001), fibrinogen (OR=3.78, p<0.0001, IL-6 (OR= 8.54, p<0.0001), CRP (OR=7.4, p<0.0001), and uric acid (OR=3.21, p=0.0001).
Conclusions: The individuals with higher inflammatory markers are at greater future risk of diabetes.