Page 221 - fbkCardioDiabetes_2017

Low Body Weight T2DM and Macro Vascular Disease 197

Highly Sensitive C-Reactive proptein
(hsCRP) :
The study revealed that, the level of hsCRP in all
three group of diabetic subjects was significantly
more than in the healthy controls but, patients with
Low bodyweight Type 2 DM had significantly lower
levels of serum hsCRP compared to obese patients
with Type 2 DM (Table 5). Raised levels of hsCRP in
Table- 3 : Values of Inflammatory Markers in plasma of Type 2 diabetics is well documented in literature. Low body-
Diabetics with and Without Macro Vascular Disease (MVD)
weight, standard weight and obese diabetics had
The levels of hsCRP were higher in diabetics, more lower values of serum adiponectin as compared
in those having MVD, as compared to healthy con- to healthy controls. Reduced adiponectin levels in
trols. Similarly the levels of adiponectin was lower in patients with Type2 DM is well recognized in world
diabetics as compared to controls. The expression of literature. However, in the present study, statistical
NF-∼B was higher in diabetics with MVD.(R10). In another significance of difference in the values of adiponec-
study, the diabetic subjects were divided into three tin was seen between Low bodyweight and standard
groups as per BMI as Low Body Weight, Normal Body bodyweight diabetics (both groups are non-obese
Weight and Obese. All the three groups of diabetics Type2 diabetics) when compared with healthy con-
were comparable with respect to age and duration trols.
of diabetes. Patients with Low bodyweight Type 2 In Low bodyweight Type 2 diabetics, values of serum
DM (group A) had significantly higher values of FBG, hsCRP were found to have significant positive cor-
2hPPBG and HbA 1c than standard body- relation with age , negative with serum total cho-
weight (Group B) and obese (Group C) diabetics. lesterol, serum HDL-C and serum LDL-C respectively.
Levels of total cholesterol were comparable in all The above correlation of hsCRP with age and HDL
the three groups of diabetics, though higher than cholesterol levels is well recognised. The negative
healthy controls ( Group D) (Table 4 ). Serum LDL-C was correlation of hsCRP with serum total cholesterol
significantly higher in Group C as compared to group and serum LDL cholesterol , and the positive cor-
A (p = 0.005), and this was significantly higher in relation of serum adiponectin levels with waist-hip
all diabetics compared to healthy controls (Table 4). ratio and HbA levels encountered in this group of
1c
Value of serum triglycerides was significantly higher diabetics is likely to be an inherent characteristic of
in Group C compared to Group B (p =0.01), and was Low bodyweight Type 2 DM. Lean habitus is most-
of a higher value compared to healthy controls.
ly due to lack of fat depot and central adiposity
Adiponectin : rather than nutritional deficiency. The above obser-
vation is an expected aberration in subjects with
Adiponectin is an adipocyte derived protein, the plas-
ma concentration of which correlates inversely with Low Bodyweight Type2 DM and compatible with our
severity of insulin resistance. earlier observations of low Homocysteine, high Glu-
cokinase and brisk hepatic metabolic state in Low
Adiponectin is anti-inflammatory in nature, and has Bodyweight type2 diabetics.
potential inhibitory activity on atherogenic cellular
phenomena . Adiponectin was shown to inhibit the Expression of Nuclear Factor Kappa-B (NF-
TNF-alpha-induced NF-kappa B activation through
the inhibition of IkB phosphorylation, which might κB) :
be a major molecular mechanism for the inhibition The levels of expression of NF-κB in peripheral blood
of monocyte adhesion to endothelial cells and thus mononuclear cells were found to be higher in di-
the inflammation . abetic subjects as compared to healthy controls.
Significant positive correlation between NF-κB ex-
Subjects with type 2 DM have been found to have pression in peripheral blood mononuclear cells and
lower adiponectin levels than healthy nondiabetic in- HbA levels has been reported previously, wherein
dividuals . 1c
exposure to hyperglycemia induced activation of
It has been found that diabetic patients have lower the transcription factor NF-kappaB in ex vivo-isolated
Adiponectin levels than control subjects . Diabetic pa- peripheral blood mononuclear cells. NF-κB belongs
tients with macroangiopathy also have lower levels to a family of transcription factors, originally identi-
of Adiponectin than those without macroangiopathy fied by B cells. These transcription factors of NF-κB
(Table 5). group are pro -inflammatory markers. NF-κB released

Cardio Diabetes Medicine