Impact of glycemic control on advanced glycation and inflammation in overweight and obese patients with type 2 diabetes mellitus

Abstract

Aim: In this study we tried to investigate the impact of glycemic control on parameters of glycation and inflammation in overweight and obese patients with type 2 diabetes mellitus. Patients and methods: Markers of glycation (HbA1c, AGEs; measured by HPLC and spectrofluorimetry, resp.) and inflammatory markers (IL-6, IL-8, TNF-α, MCP-1; measured by xMAP technology) were assessed in 69 patients with T2DM, of whom 32 were patients were with poor glycemic control (PGC group), 37 patients were with good glycemic control (GGC group) and 23 were healthy blood volunteers. Results: Our results showed that plasma levels of fluorescent AGEs, IL-6, IL-8, TNF-α, and MCP-1 were significantly increased in PGC and GGC groups in comparison with control group, while the levels were higher in PGC group in comparison with GGC group, but the difference was not significant. We found a positive correlation between AGEs and MCP-1 and between TNF-α and creatinine in PGC group. We found significantly decreased levels of glycated HbA1c and AGEs in patients who used statins compared to patients who used fibrates. We observed beneficial impact of treatment with oral antidiabetic (OAD) agents + insulin on levels of IL-8, TNF-α and TAG in comparison with treatment with insulin alone. Conclusions: Despite good glycemic compensation of patients with T2DM, levels of AGEs and inflammatory markers remained significantly elevated in comparison with healthy controls. There was a beneficial impact of treatment with OAD agents + insulin in sense of lowering the low-grade inflammation.