Lascar N, Afzal I, Nevill AM, Shabir K, Ioannis Kyrou, Brown JE, Bellary S
Background: Young-onset type 2 diabetes (T2DMY) is considered to have a more aggressive disease phenotype, unfavourable long-term outcomes, and a close association with low-grade chronic inflammation. The aim of this study was to explore the circulating inflammatory profile in a cohort of adults with T2DMY and assess its potential associations.
Methods: T2DMY adults (n=65) and non-diabetic controls (n=40) underwent detailed anthropometric and biochemical characterisation. Serum levels of six pro-inflammatory biomarkers (soluble E-selectin, IL-1β, IFN-γ, IL-6, IL-8 and angiopoietin like protein-4) were measured by Magnetic Luminex Assays and were compared between study groups. Potential associations of these biomarkers with anthropometric/biochemical parameters and microvascular complications were also tested in the T2DMY group.
Results: T2DMY patients had significantly higher circulating levels of all measured inflammatory markers compared to controls, even after adjusting for age and gender (E-selectin: 65.9 ± 4.5 vs. 37.9 ± 8.2 ng/ml; IFN-γ: 220.9 ± 7.4 vs. 160.6 ± 13.5 pg/ml; IL1-β: 50.1 ± 1.8 vs. 38.0 ± 3.3 pg/ml; IL-6: 17.5 ± 0.7 vs. 11.4 ± 1.1 pg/ml; IL-8: 18.1 ± 1.5 vs. 11.7 ± 2.4 pg/ ml; ANGPTL-4: 162.8 ± 9.8 vs. 109.0 ± 15.6 ng/ml; all p-values<0.05). Significant positive correlations were found between fat mass and IL-6 and ANGPTL-4; waist-to-hip ratio and E-selectin, IFN-γ, IL-1β and IL-6; and HbA1c and E-selectin, IFN-γ, IL-1β and IL-6. Within the T2DMY group, E-selectin was significantly elevated in patients with combined albuminuria and retinopathy compared with those without these complications (88.97 ± 43.59 vs 59.38 ± 25.28 ng/ml; p=0.003).
Conclusions: T2DMY patients exhibit an adverse profile of key circulating pro-inflammatory biomarkers, which appears associated with worse anthropometric/biochemical parameters and microvascular complications. The role of these biomarkers as predictors of T2DMY and disease progression should be further elucidated.