Main Article Content
Introduction: Prediabetes is associated with dysglycemia, endothelial dysfunction, obesity and inflammation, placing them at an increased risk of cardiovascular events.
Aims: The present study aimed to investigate the risk of cardiovascular disease associated with prediabetes by estimation of serum interleukin-6, myeloperoxidase and urine microalbumin and their correlation with fasting plasma glucose and anthropometric measurements.
Study Design: Cross sectional study.
Place and Duration of Study: Study was conducted at Department of Biochemistry, Kasturba Medical College Hospitals, Mangaluru between 2014 and 2015.
Methodology: Eighty subjects were categorised into prediabetes and healthy controls based on their fasting plasma glucose values. Anthropometric data (weight, body mass index, waist circumference, hip circumference and waist-to-hip ratio from all subjects were recorded. Interleukin-6 & myeloperoxidase were estimated in serum sample whereas microalbumin was estimated in random urine sample.
Results: The mean anthropometric measurements and cardiovascular disease risk markers (interleukin-6, myeloperoxidase and urine microalbumin) were found to be significantly higher (p < 0.05) in prediabetes group. Myeloperoxidase had significant correlation with fasting plasma glucose (r-0.388) in the prediabetes group. Interleukin-6 and myeloperoxidase also showed a positive correlation with body mass index (r - 0.339, r - 0.327), waist circumference (r - 484, r - 0.493) and waist-to-hip ratio (r - 0.430, r - 0.493) while urine microalbumin did not correlate with fasting plasma glucose and anthropometric measurements in prediabetes group.
Conclusion: This study suggests that prediabetes is associated with central adiposity and have an increased risk for cardiovascular disease.
Wegner M, Araszkiewicz A, Stolzmann MP, Wysocka BW, Ziolkiewicz DZ. Association between IL-6 concentration and diabetes-related variables in DM1 patients with and without microvascular complications. Inflammation. 2013;36(3): 723-8.
Schindhelm RK, Zwan LP, Teerlink T, Scheffer P. Myeloperoxidase: A useful biomarker for cardiovascular disease risk stratification? Clin Chem. 2009;55(8): 1462–70.
Chowta NK, Pant P, Chowta MK. Microalbuminuria in diabetes mellitus: Association with age, sex, weight and creatinine clearance. Indian J Nephrol. 2009;19(2):53–6.
Rothenbacher D, Kleiner A, Koenig W, Primatesta P, Breitling LP, Brenner H. Relationship between inflammatory cytokines and uric acid levels with adverse cardiovascular outcomes in patients with stable coronary heart disease. PLoS One. 2012;7(9):1-8.
Naidoo DP. The link between microalbuminuria, endothelial dysfunction and cardiovascular disease in diabetes. Cardiovas J. SA. 2002;13:194-9.
Ferrannini E. Definition of intervention points in prediabetes. Lancet Diabetes Endocrinol. 2014;2(8):667-75.
Hartge MM, Unger T, Kintscher U. The endothelium and vascular inflammation in diabetes. Diab Vasc Dis Res. 2007;4(2): 84–8.
Fisman EZ, Tenenbaum A. The ubiquitous interleukin-6: A time for reappraisal. Cardiovasc Diabetol. 2010;9:62-8.
Marcovecchio ML, Dalton RN, Prevost AT, Acerini CL, Barrett TG, Cooper JD, et al. Prevalence of abnormal lipid profiles and the relationship with the development of microalbuminuria in adolescents with type 1 diabetes. Diabetes Care. 2009;32:658–63.
Nevado, J, Peiró C, Vallejo S, El-Assar M, Lafuente N, Matesanz N, et al. Amadori adducts activate nuclear factor-kappaB-related proinflammatory genes in cultured human peritoneal mesothelial cells. Br J Pharmacol 2005;146:268–79.
Hossain M, Faruque MO, Kabir G, Hassan N, Sikdar D, Nahar Q, et al. Association of serum TNF-α and IL-6 with insulin secretion and insulin resistance in IFG and IGT subjects in a Bangladeshi population. Int J Diabetes Mellit. 2010;2:165-8.
Illán-Gómez F, Gonzálvez-Ortega M, Orea-Soler I, Alcaraz-Tafalla MS, Aragón-Alonso A, Pascual-Díaz M, et al. Obesity and inflammation: Change in adiponectin, C-reactive protein, tumour necrosis factor-alpha and interleukin-6 after bariatric surgery. Obes Surg. 2012;22:950–5.
Sommer G, Kralisch S, Stangl V, Vietzke A, Köhler U, Stepan H, et al. Secretory products from human adipocytes stimulate proinflammatory cytokine secretion from human endothelial cells. J Cell Biochem. 2009;106:729–37.
Wilkinson CP, Ferris FL 3rd, Klein RE, Lee PP, Agardh CD, Davis M, et al. Global Diabetic Retinopathy Project Group. Proposed international clinical diabetic retinopathy and diabetic macular edema disease severity scales. Ophthalmology 2003;110:1677–82.
Jialal I, Kaur H. The role of toll-like receptors in diabetes-induced inflamma-tion: Implications for vascular complica-tions. Curr Diab Rep. 2012;12(2):172-9.
Bandeira SM, Guedes GS, da Fonseca LJ, Pires AS, Gelain DP, Moreira JC, et al. Characterization of blood oxidative stress in type 2 diabetes mellitus patients: increase in lipid peroxidation and SOD activity. Oxid Med Cell Longev. 2012; 2012:13.
Shetty S, Kumari SN, Madhu LN. Variations in serum myeloperoxidase levels with respect to hyperglycemia, duration of diabetes, BMI, sex and aging in type 2 Diabetes mellitus. IJRPBS. 2012; 3(2):652-5.
Eiserich JP, Baldus S, Brennan ML, Ma W, Zhang C, Tousson A, et al. Myeloperoxidase, a leukocyte-derived vascular no oxidase. Science. 2002;296: 2391–4.
Nuszkowski A, Grabner R, Marsche G, Unbehaun A, Malle E, Heller R. Hypochlorite modified low density lipoprotein inhibits nitric oxide synthesis in endothelial cells via an intracellular dislocalization of endothelial nitric-oxide synthase. J Biol Chem. 2001;276:14212–21.
Van der Zwan LP, Scheffer PG, Dekker JM, Stehouwer CD, Heine RJ, Teerlink T. Hyperglycemia and oxidative stress strengthen the association between myeloperoxidase and blood pressure. Hypertension. 2010;55(6):1366-72.
Fujita K, Nishizawa H, Funahashi T, Shimomura I, Shimabukuro M. Systemic oxidative stress is associated with visceral fat accumulation and the metabolic syndrome. Circ J. 2006;70(11):1437-42.
Zacharias JM, Young TK, Riediger ND, Roulette J, Bruce SG. Prevalence, risk factors and awareness of albuminuria on a Canadian First Nation: A community-based screening study. BMC Public Health. 2012;12:290-8.
Garg JP, Bakris GL. Microalbuminuria: Marker of vascular dysfunction, risk factor for cardiovascular disease. Vascular Medicine. 2002;7:35-43.
Palaniappan L, Carnethon M, Fortmann SP. Association between microalbuminuria and the metabolic syndrome: Nhanes III. AJH. 2003;16:952–8.
Tapp RJ, Shaw JE, Zimmet PZ Balkau B, Chadban SJ, Tonkin AM, et al. Albuminuria is evident in the early stages of diabetes onset: Results from the Australian Diabetes, Obesity, and Lifestyle Study (AusDiab). Am J Kidney Dis. 2004;44:792–8.
Ritz E, Viberti GC, Ruilope LM, Rabelink AJ, Izzo Jr JL, Katayama S, et al. Determinants of urinary albumin excretion within the normal range in patients with type 2 diabetes: The randomised Olmesartan and Diabetes Microal-buminuria Prevention (ROADMAP) study. Diabetologia 2010;53:49–57.
Cirillo M, Senigalliesi L, Laurenzi M, Alfieri R, Stamler J, Stamler R, et al. Microalbuminuria in nondiabetic adults relation of blood pressure, body mass index, plasma cholesterol levels and smoking: The Gubbio population study. Arch Intern Med. 1998;158(17):1933-9.
Chang Y, Yoo T, Ryu S, Huh BY, Cho BL, Sung E, et al. Abdominal obesity, systolic blood pressure and microalbuminuria in normotensive and euglycemic Korean men. Int J Obes. 2006;30:800–4